Successful sedation with remimazolam and alfentanil in a child susceptible to malignant hyperthermia: a case report
Abstract Background Malignant hyperthermia (MH) is a life-threatening autosomal-dominant disorder caused by mutations in the ryanodine receptor 1 (RYR1) gene, leading to calcium dysregulation in skeletal muscle. Patients with genetically confirmed MH susceptibility must strictly avoid volatile anest...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-04-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-025-03076-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849311117288931328 |
|---|---|
| author | Kailai Zhu Shuangwei Wu Xianglin Hao Chuanguang Wang |
| author_facet | Kailai Zhu Shuangwei Wu Xianglin Hao Chuanguang Wang |
| author_sort | Kailai Zhu |
| collection | DOAJ |
| description | Abstract Background Malignant hyperthermia (MH) is a life-threatening autosomal-dominant disorder caused by mutations in the ryanodine receptor 1 (RYR1) gene, leading to calcium dysregulation in skeletal muscle. Patients with genetically confirmed MH susceptibility must strictly avoid volatile anesthetics and succinylcholine. Intravenous sedation presents a viable alternative, yet evidence supporting remimazolam use in pediatric MH patients remains scarce. Case presentation We report the first case of a 1-year-old male patient with genetically confirmed MH susceptibility undergoing orchidopexy under remimazolam-alfentanil sedation combined with caudal block. The patient had no MH manifestations intraoperatively or postoperatively and recovered uneventfully. Conclusion This case demonstrates the feasibility of remimazolam-based sedation in genetically confirmed pediatric MH patients, supporting its safety profile in this population. Further multicenter studies are needed to establish standardized protocols. |
| format | Article |
| id | doaj-art-0e20dd0827344b709c6bfe8a06ddbe3c |
| institution | Kabale University |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj-art-0e20dd0827344b709c6bfe8a06ddbe3c2025-08-20T03:53:32ZengBMCBMC Anesthesiology1471-22532025-04-012511410.1186/s12871-025-03076-0Successful sedation with remimazolam and alfentanil in a child susceptible to malignant hyperthermia: a case reportKailai Zhu0Shuangwei Wu1Xianglin Hao2Chuanguang Wang3Department of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central HospitalDepartment of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central HospitalDepartment of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central HospitalDepartment of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central HospitalAbstract Background Malignant hyperthermia (MH) is a life-threatening autosomal-dominant disorder caused by mutations in the ryanodine receptor 1 (RYR1) gene, leading to calcium dysregulation in skeletal muscle. Patients with genetically confirmed MH susceptibility must strictly avoid volatile anesthetics and succinylcholine. Intravenous sedation presents a viable alternative, yet evidence supporting remimazolam use in pediatric MH patients remains scarce. Case presentation We report the first case of a 1-year-old male patient with genetically confirmed MH susceptibility undergoing orchidopexy under remimazolam-alfentanil sedation combined with caudal block. The patient had no MH manifestations intraoperatively or postoperatively and recovered uneventfully. Conclusion This case demonstrates the feasibility of remimazolam-based sedation in genetically confirmed pediatric MH patients, supporting its safety profile in this population. Further multicenter studies are needed to establish standardized protocols.https://doi.org/10.1186/s12871-025-03076-0Malignant hyperthermiaRemimazolamPediatric anesthesiaRYR1 mutationSedation |
| spellingShingle | Kailai Zhu Shuangwei Wu Xianglin Hao Chuanguang Wang Successful sedation with remimazolam and alfentanil in a child susceptible to malignant hyperthermia: a case report BMC Anesthesiology Malignant hyperthermia Remimazolam Pediatric anesthesia RYR1 mutation Sedation |
| title | Successful sedation with remimazolam and alfentanil in a child susceptible to malignant hyperthermia: a case report |
| title_full | Successful sedation with remimazolam and alfentanil in a child susceptible to malignant hyperthermia: a case report |
| title_fullStr | Successful sedation with remimazolam and alfentanil in a child susceptible to malignant hyperthermia: a case report |
| title_full_unstemmed | Successful sedation with remimazolam and alfentanil in a child susceptible to malignant hyperthermia: a case report |
| title_short | Successful sedation with remimazolam and alfentanil in a child susceptible to malignant hyperthermia: a case report |
| title_sort | successful sedation with remimazolam and alfentanil in a child susceptible to malignant hyperthermia a case report |
| topic | Malignant hyperthermia Remimazolam Pediatric anesthesia RYR1 mutation Sedation |
| url | https://doi.org/10.1186/s12871-025-03076-0 |
| work_keys_str_mv | AT kailaizhu successfulsedationwithremimazolamandalfentanilinachildsusceptibletomalignanthyperthermiaacasereport AT shuangweiwu successfulsedationwithremimazolamandalfentanilinachildsusceptibletomalignanthyperthermiaacasereport AT xianglinhao successfulsedationwithremimazolamandalfentanilinachildsusceptibletomalignanthyperthermiaacasereport AT chuanguangwang successfulsedationwithremimazolamandalfentanilinachildsusceptibletomalignanthyperthermiaacasereport |