Key result
Remimazolam safely preserves hemodynamics without vasopressors during general anesthesia in severe aortic stenosis.
Why the study?
High-risk surgeries for patients with severe aortic stenosis are challenging and can cause hemodynamic deterioration and mortality, necessitating safe anesthesia options.
Does remimazolam maintain hemodynamic stability in patients with severe aortic stenosis undergoing high-risk noncardiac surgery?
Case Report (n=1)
No
Does remimazolam maintain hemodynamic stability in patients with severe aortic stenosis undergoing high-risk noncardiac surgery?
Remimazolam may be a safe and effective agent for inducing and maintaining general anesthesia in patients with severe aortic stenosis undergoing high-risk noncardiac surgery.
Hypothesis-generating for remimazolam in severe aortic stenosis; leaves open its role pending controlled trials.
High-risk surgeries for patients with severe aortic stenosis (AS) are challenging for anesthesiologists and can result in hemodynamic deterioration and even mortality. We describe a case in which remimazolam was used to induce and maintain general anesthesia for a high-risk, noncardiac surgery accompanied by ongoing bleeding. An 86-year-old man with severe AS was scheduled to undergo proximal gastrectomy due to ongoing gastrointestinal bleeding and severe anemia. Remimazolam, a novel, ultra-short-acting benzodiazepine, was administered along with remifentanil for the induction and maintenance of general anesthesia. Throughout the anesthetic process, the patient's cardiac index and systemic vascular resistance were well preserved without any vasopressor support. Remimazolam seems to have possible effectiveness as a relatively safe agent for the induction and maintenance of general anesthesia in patients with severe AS who are undergoing high-risk, noncardiac surgery with bleeding.
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Kim et al. (2022) conducted a case report in Severe aortic stenosis (n=1). Remimazolam was evaluated on Hemodynamic stability (cardiac index and systemic vascular resistance). Remimazolam safely induced and maintained general anesthesia while preserving cardiac index and systemic vascular resistance without vasopressor support in a patient with severe aortic stenosis.
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