Successful reversal of remimazolam anesthesia in a “cannot intubate, can ventilate” situation: a case report
Abstract Background Compared to other intravenous anesthetics, availability of a specific antagonist flumazenil is a clear advantage of remimazolam. We report a patient who could be rapidly woken up when laryngoscopy and tracheal intubation were unexpectedly difficult. Case presentation A 62-year-ol...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2023-07-01
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| Series: | JA Clinical Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40981-023-00638-4 |
| _version_ | 1827890548913995776 |
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| author | Shota Sekimoto Shuya Kiyama Shoichi Uezono |
| author_facet | Shota Sekimoto Shuya Kiyama Shoichi Uezono |
| author_sort | Shota Sekimoto |
| collection | DOAJ |
| description | Abstract Background Compared to other intravenous anesthetics, availability of a specific antagonist flumazenil is a clear advantage of remimazolam. We report a patient who could be rapidly woken up when laryngoscopy and tracheal intubation were unexpectedly difficult. Case presentation A 62-year-old man was scheduled to have resection of a small gingival tumor. Preoperative airway examination was unremarkable except for an omega-shaped epiglottis. Anesthesia was induced with remifentanil/remimazolam infusion and rocuronium. A small omega-shaped edematous epiglottis precluded identification of glottis. Consciousness and spontaneous ventilation were rapidly restored after administration of flumazenil and sugammadex. Tracheostomy was done under local anesthesia while the patient breathed spontaneously. Conclusions Remimazolam can be a reasonable induction agent when there are concerns regarding airway management. Avoiding repeated airway manipulations is extremely important to prevent deterioration into a “cannot intubate, cannot ventilate (CICV)” emergency. |
| first_indexed | 2024-03-12T21:11:17Z |
| format | Article |
| id | doaj.art-ba10380fd74f4ef39946823875d094a9 |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-03-12T21:11:17Z |
| publishDate | 2023-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-ba10380fd74f4ef39946823875d094a92023-07-30T11:09:42ZengSpringerOpenJA Clinical Reports2363-90242023-07-01911410.1186/s40981-023-00638-4Successful reversal of remimazolam anesthesia in a “cannot intubate, can ventilate” situation: a case reportShota Sekimoto0Shuya Kiyama1Shoichi Uezono2Department of Anesthesiology, School of Medicine, The Jikei UniversityDepartment of Anesthesiology, School of Medicine, The Jikei UniversityDepartment of Anesthesiology, School of Medicine, The Jikei UniversityAbstract Background Compared to other intravenous anesthetics, availability of a specific antagonist flumazenil is a clear advantage of remimazolam. We report a patient who could be rapidly woken up when laryngoscopy and tracheal intubation were unexpectedly difficult. Case presentation A 62-year-old man was scheduled to have resection of a small gingival tumor. Preoperative airway examination was unremarkable except for an omega-shaped epiglottis. Anesthesia was induced with remifentanil/remimazolam infusion and rocuronium. A small omega-shaped edematous epiglottis precluded identification of glottis. Consciousness and spontaneous ventilation were rapidly restored after administration of flumazenil and sugammadex. Tracheostomy was done under local anesthesia while the patient breathed spontaneously. Conclusions Remimazolam can be a reasonable induction agent when there are concerns regarding airway management. Avoiding repeated airway manipulations is extremely important to prevent deterioration into a “cannot intubate, cannot ventilate (CICV)” emergency.https://doi.org/10.1186/s40981-023-00638-4RemimazolamFlumazenilEpiglottisDifficult laryngoscopyCICV |
| spellingShingle | Shota Sekimoto Shuya Kiyama Shoichi Uezono Successful reversal of remimazolam anesthesia in a “cannot intubate, can ventilate” situation: a case report JA Clinical Reports Remimazolam Flumazenil Epiglottis Difficult laryngoscopy CICV |
| title | Successful reversal of remimazolam anesthesia in a “cannot intubate, can ventilate” situation: a case report |
| title_full | Successful reversal of remimazolam anesthesia in a “cannot intubate, can ventilate” situation: a case report |
| title_fullStr | Successful reversal of remimazolam anesthesia in a “cannot intubate, can ventilate” situation: a case report |
| title_full_unstemmed | Successful reversal of remimazolam anesthesia in a “cannot intubate, can ventilate” situation: a case report |
| title_short | Successful reversal of remimazolam anesthesia in a “cannot intubate, can ventilate” situation: a case report |
| title_sort | successful reversal of remimazolam anesthesia in a cannot intubate can ventilate situation a case report |
| topic | Remimazolam Flumazenil Epiglottis Difficult laryngoscopy CICV |
| url | https://doi.org/10.1186/s40981-023-00638-4 |
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