Anaesthetic management using remimazolam in a patient with severe aortic stenosis: a case report

BMC Anesthesiol. 2021 Aug 14;21(1):202. doi: 10.1186/s12871-021-01422-6.

Abstract

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.

Keywords: aortic stenosis; circulatory dynamics; remimazolam.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Anesthetics, Intravenous / administration & dosage*
  • Anesthetics, Intravenous / adverse effects
  • Aortic Valve Stenosis / physiopathology*
  • Benzodiazepines / administration & dosage*
  • Benzodiazepines / adverse effects
  • Cardiac Output / physiology
  • Female
  • Hemodynamics / physiology
  • Humans
  • Mastectomy / methods*

Substances

  • Anesthetics, Intravenous
  • Benzodiazepines
  • remimazolam