Case report of atypical re-sedation after general anesthesia using remimazolam
- Author:
Soo Jee LEE
1
;
Insik JUNG
;
Seongmin PARK
;
Seunghee KI
Author Information
- Publication Type:Case Report
- From:Anesthesia and Pain Medicine 2024;19(4):320-325
- CountryRepublic of Korea
- Language:English
- Abstract: Remimazolam, an ultra-short-acting anesthetic with flumazenil as a reversal agent, typically facilitates patient awakening postoperatively. However, our case reveals an unusual occurrence: despite flumazenil initially restoring consciousness, re-sedation due to remimazolam ensued six hours later. Case: A 65-year-old woman underwent total intravenous general anesthesia with remimazolam and remifentanil during the 140-min surgery. Despite an initially smooth recovery, she progressively became drowsy upon transfer to the general ward, eventually reaching a stuporous state. Multiple interventions, including opioid reversal (intravenous patient-controlled analgesia discontinuation, and naloxone administration) were attempted. Neurological consultation revealed no issues; however, immediate improvement after flumazenil administration suggested remimazolam’s involvement. The patient was discharged without complications. Conclusions: This case challenges our understanding of remimazolam’s dynamics, emphasizing the necessity for vigilant post-anesthesia monitoring, even in seemingly low-risk cases. It advocates for standardized response protocols to promptly manage unforeseen events and ensure patient safety.
