Kosin Med J.  2024 Jun;39(2):144-149. 10.7180/kmj.23.156.

Total intravenous anesthesia using remimazolam for patients with heart failure with reduced ejection fraction: a case series

• Lee J
• Yoon JU
• Byeon GJ
• Shon HS
• Yi A
• Kim HY

• KMID: 2556813
• DOI: http://doi.org/10.7180/kmj.23.156

Abstract

Patients with heart failure undergoing surgery that requires general anesthesia face substantial perioperative risks; however, clear guidelines are not available for anesthesia management in patients with a reduced left ventricular ejection fraction. Traditional intravenous and volatile anesthetics require careful administration to prevent severe hypotension and bradycardia in patients with heart failure. Remimazolam has emerged as a promising alternative to conventional anesthetics because of its reduced cardiovascular depressive effects. We present three cases illustrating the successful use of remimazolam to induce and maintain general anesthesia in patients with heart failure and reduced cardiac function. Our cases demonstrate the safe use of remimazolam for general anesthesia in patients with heart failure and a reduced ejection fraction.

Keyword

Anesthesia; Case reports; Heart failure; Left ventricular ejection fraction; Remimazolam

Figure

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  Fig. 1. Changes in hemodynamic status under general anesthesia. (A) Case 1. (B) Case 2. (C) Case 3. ABPs, systolic artery blood pressure; ABPd, diastolic artery blood pressure; bpm, beats per minute; HR, heart rate; ⅹ, beginning or ending of anesthesia; ▲, endotracheal intubation or extubation; ●, start or end of surgery.

Reference

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