PDF(Pubmed)
Abstract：
BACKGROUND: The goal of anesthesia in patients with hypertrophic obstructive cardiomyopathy (HOCM) is to reduce the risk of left ventricular outflow tract obstruction triggered by anesthetics. Remimazolam is a newly developed anesthetic that has been reported to have superior hemodynamic stability. There have been no reports on the completion of non-cardiac surgery with remimazolam in patients with HOCM.
METHODS: Here we report the case of a 49-year-old man diagnosed with hypertrophic obstructive cardiomyopathy who underwent resection of colon cancer with remimazolam and remifentanil anesthesia. A bolus 0.3 mg/kg remimazolam was administered for anesthesia induction, and then adjusted to 2 mg/kg/h to maintain anesthesia. Set the pain threshold index to 50 to auto-control the infusion speed of remifentanil.
RESULTS: No hypotension occurred during anesthesia, and norepinephrine was not administered. After conversion to open surgery, the patient\'s blood pressure elevated and reduced with urapidil and esmolol.
CONCLUSIONS: In this patient with HOCM, remimazolam and remifentanil provided adequate anesthesia for induction and maintenance to complete the right hemicolectomy.
METHODS: Here we report the case of a 49-year-old man diagnosed with hypertrophic obstructive cardiomyopathy who underwent resection of colon cancer with remimazolam and remifentanil anesthesia. A bolus 0.3 mg/kg remimazolam was administered for anesthesia induction, and then adjusted to 2 mg/kg/h to maintain anesthesia. Set the pain threshold index to 50 to auto-control the infusion speed of remifentanil.
RESULTS: No hypotension occurred during anesthesia, and norepinephrine was not administered. After conversion to open surgery, the patient\'s blood pressure elevated and reduced with urapidil and esmolol.
CONCLUSIONS: In this patient with HOCM, remimazolam and remifentanil provided adequate anesthesia for induction and maintenance to complete the right hemicolectomy.
摘要：
背景：肥厚型梗阻性心肌病（HOCM）患者的麻醉目标是降低由麻醉药引发的左心室流出道阻塞的风险。瑞咪唑安定是一种新开发的麻醉药，据报道具有优越的血液动力学稳定性。尚未有关于HOCM患者使用雷米马唑仑完成非心脏手术的报道。
方法：这里我们报告一例49岁的男性患者，诊断为肥厚性梗阻性心肌病，接受了结肠癌切除术，用瑞马唑仑和瑞芬太尼麻醉。给药0.3mg/kg瑞米唑仑用于麻醉诱导，然后调整到2mg/kg/h以保持麻醉。设定痛阈指数50自动控制瑞芬太尼的输注速度。
结果：麻醉期间未发生低血压，没有服用去甲肾上腺素.转换为开放手术后，患者的血压升高和降低与乌拉地尔和艾司洛尔。
结论：在患有HOCM的患者中，瑞咪唑安定和瑞芬太尼为完成右半结肠切除术的诱导和维持提供了足够的麻醉.
方法：这里我们报告一例49岁的男性患者，诊断为肥厚性梗阻性心肌病，接受了结肠癌切除术，用瑞马唑仑和瑞芬太尼麻醉。给药0.3mg/kg瑞米唑仑用于麻醉诱导，然后调整到2mg/kg/h以保持麻醉。设定痛阈指数50自动控制瑞芬太尼的输注速度。
结果：麻醉期间未发生低血压，没有服用去甲肾上腺素.转换为开放手术后，患者的血压升高和降低与乌拉地尔和艾司洛尔。
结论：在患有HOCM的患者中，瑞咪唑安定和瑞芬太尼为完成右半结肠切除术的诱导和维持提供了足够的麻醉.
