Key result
Remimazolam preserves cardiac output in a severe AS case despite transient hypotension.
Why the study?
The administration of general anaesthesia in patients with severe aortic stenosis requires careful attention to haemodynamics to avoid cardiac suppression.
Does remimazolam preserve cardiac output during general anaesthesia in a patient with severe aortic stenosis?
Case Report (n=1)
No
Does remimazolam preserve cardiac output during general anaesthesia in a patient with severe aortic stenosis?
Remimazolam can be safely used for general anaesthesia to preserve cardiac output in patients with severe aortic stenosis.
Remimazolam may be considered in severe aortic stenosis anaesthesia; single case leaves open need for prospective validation.
BACKGROUND: The administration of general anaesthesia in patients with aortic stenosis (AS) requires careful attention to haemodynamics. We used remimazolam for the induction and maintenance of anaesthesia in a woman with severe AS undergoing a total mastectomy. CASE PRESENTATION: An 81-year-old woman with severe AS was scheduled to undergo a total mastectomy. We decided to administer total intravenous anaesthesia with remimazolam to minimize haemodynamic changes. Although the patient showed transient hypotension after anaesthesia induction, the cardiac index was preserved with a low dose of continuous noradrenaline. The anaesthesia was then safely maintained without a decrease in the patient's cardiac index. CONCLUSIONS: General anaesthesia using remimazolam preserved cardiac output in this patient; therefore, remimazolam can be safely used to avoid the risk of cardiac suppression in patients with severe AS.
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Furuta et al. (2021) conducted a case report in Severe aortic stenosis (n=1). Remimazolam was evaluated on Haemodynamic stability (cardiac index). General anaesthesia using remimazolam preserved cardiac output in an 81-year-old woman with severe aortic stenosis, despite transient hypotension after induction.
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