Postoperative Heart Failure with Preserved Ejection Fraction Induced by Flumazenil Administered for Remimazolam Antagonism
Remimazolam is an ultrashort-acting benzodiazepine intravenous anesthetic characterized by rapid awakening after anesthesia. However, the method for administering remimazolam in clinical practice remains unclear. Here, we report a case of postoperative heart failure with preserved ejection fraction...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2022/8923008 |
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| author | Keito Koh Takeshi Omae Sonoko Sakuraba Masateru Kumemura Sho Yamazaki Hiroshi Yunoki |
| author_facet | Keito Koh Takeshi Omae Sonoko Sakuraba Masateru Kumemura Sho Yamazaki Hiroshi Yunoki |
| author_sort | Keito Koh |
| collection | DOAJ |
| description | Remimazolam is an ultrashort-acting benzodiazepine intravenous anesthetic characterized by rapid awakening after anesthesia. However, the method for administering remimazolam in clinical practice remains unclear. Here, we report a case of postoperative heart failure with preserved ejection fraction (HFpEF) after antagonizing remimazolam with flumazenil. An 82-year-old woman was scheduled to undergo lumbar laminectomy for lumbar spinal canal stenosis. Preoperative echocardiography revealed normal left ventricular systolic function, left atrial enlargement, and impaired left ventricular diastolic function. General anesthesia was induced with 10 mg/kg/h remimazolam and maintained with 0.8 mg/kg/h remimazolam intraoperatively. Before extubation, a total of 1.0 mg of flumazenil was administered. After extubation, the patient developed pulmonary edema due to HFpEF. When remimazolam is administered in elderly patients with cardiac dysfunction, the maintenance dose should be customized according to the patient’s general condition to minimize the dosage of flumazenil. |
| format | Article |
| id | doaj-art-4715a9231e5e4dfb84e41b492e039d45 |
| institution | DOAJ |
| issn | 2090-6390 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-4715a9231e5e4dfb84e41b492e039d452025-08-20T02:39:20ZengWileyCase Reports in Anesthesiology2090-63902022-01-01202210.1155/2022/8923008Postoperative Heart Failure with Preserved Ejection Fraction Induced by Flumazenil Administered for Remimazolam AntagonismKeito Koh0Takeshi Omae1Sonoko Sakuraba2Masateru Kumemura3Sho Yamazaki4Hiroshi Yunoki5Department of Anesthesiology and Pain MedicineDepartment of Anesthesiology and Pain MedicineDepartment of Anesthesiology and Pain MedicineDepartment of Anesthesiology and Pain MedicineDepartment of Anesthesiology and Pain MedicineDepartment of AnesthesiologyRemimazolam is an ultrashort-acting benzodiazepine intravenous anesthetic characterized by rapid awakening after anesthesia. However, the method for administering remimazolam in clinical practice remains unclear. Here, we report a case of postoperative heart failure with preserved ejection fraction (HFpEF) after antagonizing remimazolam with flumazenil. An 82-year-old woman was scheduled to undergo lumbar laminectomy for lumbar spinal canal stenosis. Preoperative echocardiography revealed normal left ventricular systolic function, left atrial enlargement, and impaired left ventricular diastolic function. General anesthesia was induced with 10 mg/kg/h remimazolam and maintained with 0.8 mg/kg/h remimazolam intraoperatively. Before extubation, a total of 1.0 mg of flumazenil was administered. After extubation, the patient developed pulmonary edema due to HFpEF. When remimazolam is administered in elderly patients with cardiac dysfunction, the maintenance dose should be customized according to the patient’s general condition to minimize the dosage of flumazenil.http://dx.doi.org/10.1155/2022/8923008 |
| spellingShingle | Keito Koh Takeshi Omae Sonoko Sakuraba Masateru Kumemura Sho Yamazaki Hiroshi Yunoki Postoperative Heart Failure with Preserved Ejection Fraction Induced by Flumazenil Administered for Remimazolam Antagonism Case Reports in Anesthesiology |
| title | Postoperative Heart Failure with Preserved Ejection Fraction Induced by Flumazenil Administered for Remimazolam Antagonism |
| title_full | Postoperative Heart Failure with Preserved Ejection Fraction Induced by Flumazenil Administered for Remimazolam Antagonism |
| title_fullStr | Postoperative Heart Failure with Preserved Ejection Fraction Induced by Flumazenil Administered for Remimazolam Antagonism |
| title_full_unstemmed | Postoperative Heart Failure with Preserved Ejection Fraction Induced by Flumazenil Administered for Remimazolam Antagonism |
| title_short | Postoperative Heart Failure with Preserved Ejection Fraction Induced by Flumazenil Administered for Remimazolam Antagonism |
| title_sort | postoperative heart failure with preserved ejection fraction induced by flumazenil administered for remimazolam antagonism |
| url | http://dx.doi.org/10.1155/2022/8923008 |
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