Evaluation of total intravenous anesthesia with remimazolam in general anesthesia for pulmonary endarterectomy of chronic thromboembolic pulmonary hypertension: a case report

Sae Igarashi; Yusuke Ishida; Shunya Sekiguchi; Yosuke Fujita; Aya Kawachi; Mikiko Tomino

doi:10.1186/s40981-023-00626-8

Evaluation of total intravenous anesthesia with remimazolam in general anesthesia for pulmonary endarterectomy of chronic thromboembolic pulmonary hypertension: a case report

JA Clin Rep. 2023 Jun 12;9(1):34. doi: 10.1186/s40981-023-00626-8.

Authors

Sae Igarashi¹, Yusuke Ishida², Shunya Sekiguchi¹, Yosuke Fujita¹, Aya Kawachi¹, Mikiko Tomino¹

Affiliations

¹ Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
² Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. yishida14anes@gmail.com.

Abstract

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.

Keywords: Chronic thromboembolic pulmonary hypertension (CTEPH); Pulmonary endarterectomy (PEA); Pulmonary vascular resistance (PVR); Remimazolam.