A New Anesthetic, Remimazolam, Is Useful in the Management of Anesthesia in Patients with Liver Cirrhosis. (7th May 2022)

• Record Type: Journal Article
• Authors: Onoda, Anna; Suzuki, Yasuyuki
• Other Names: Trikha Anjan Academic Editor.
• Is Part Of: Case reports in anesthesiology. Volume 2022(2022)
• Publication Date: 2022-05-07
• Subjects: Anesthesiology -- Periodicals; 617.9605
• DOI: 10.1155/2022/9268454
• Languages: English
• ISSNs: 2090-6382

Abstract

Abstract : Background . Management of general anesthesia in patients with liver cirrhosis is challenging because it is difficult to maintain the circulation and concentration of anesthetics within a safe range. Unlike many other anesthetics, which are metabolized by cytochrome P450 enzymes, remimazolam is metabolized by carboxylesterase. In a liver cirrhosis model, cytochrome P450 activity is suppressed by approximately 30%; however, carboxylesterase activity is maintained at approximately 60%. Also, remimazolam is less likely to inhibit circulation. A 77-year-old woman was scheduled to undergo laparoscopic cholecystectomy. The patient was diagnosed with Child-Pugh B liver cirrhosis due to type C viral hepatitis. General anesthesia with remimazolam stabilized the intraoperative circulation and resulted in rapid postoperative awakening. Conclusion . We report a case in which a patient with Child-Pugh B cirrhosis was safely managed under general anesthesia using remimazolam during laparoscopic cholecystectomy.