Key result
Remimazolam provided stable hemodynamics without circulatory failure or significant increase in pulmonary vascular resistance during pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension.
Why the study?
Anesthetic management in pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension requires agents that prevent increased pulmonary vascular resistance and circulatory failure, and the safety of remimazolam in this setting needed evaluation.
Does remimazolam provide safe anesthetic management in a patient undergoing pulmonary endarterectomy for CTEPH?
Case Report (n=1)
No
Does remimazolam provide safe anesthetic management in a patient undergoing pulmonary endarterectomy for CTEPH?
Remimazolam can be safely used for anesthetic management during pulmonary endarterectomy for CTEPH without causing circulatory failure or increased pulmonary vascular resistance.
Remimazolam may suit PEA anesthesia in CTEPH; leaves open confirmation of hemodynamic benefits versus standard agents in trials.
BACKGROUND: Pulmonary endarterectomy (PEA) is a treatment modality for chronic thromboembolic pulmonary hypertension (CTEPH). PEA requires anesthesia management to prevent an increase in pulmonary vascular resistance (PVR) and circulatory failure. Therefore, it is necessary to select an anesthetic agent that can achieve these goals as much as possible. On the other hand, remimazolam, a short-acting sedative, was launched in Japan in 2020, and its use in various cases has been increasingly reported. This report demonstrates that remimazolam can be used safely in the anesthetic management of PEA. CASE PRESENTATION: A 57-year-old man was scheduled to undergo PEA for CTEPH. Remimazolam was used for sedation from induction of anesthesia. Hemodynamics were stable during surgery without circulatory failure. Anesthesia was managed intraoperatively without any particular increase in PVR. DISCUSSION: Anesthesia was successfully managed without any complications. This case suggests that remimazolam is one of the options for anesthetic management in PEA.
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Igarashi et al. (2023) conducted a case report in Chronic thromboembolic pulmonary hypertension (CTEPH) (n=1). Remimazolam was evaluated on Hemodynamic stability (pulmonary vascular resistance and pulmonary arterial pressure). Remimazolam provided stable hemodynamics without circulatory failure or significant increase in pulmonary vascular resistance during pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension.
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