Use of remimazolam in living donor liver transplantation: a case report

• DOI: 10.1186/s40981-022-00556-x
• Publication Date: 2022-08-22T01:02:32Z
• Authors: Tsuguhiro Matsumoto; Kotaro Sakurai; Kazuyo Takahashi; Shuji Kawamoto
• Keywords: RC86-88.9; Living donor liver transplantation; Medical emergencies. Critical care. Intensive care. First aid; Case Report; Hemodynamic stability; 3. Good health; Malignant hyperthermia; 03 medical and health sciences; 0302 clinical medicine; Anesthesiology; RD78.3-87.3; Remimazolam

Abstract Background Remimazolam is an intravenous ultra-short-acting benzodiazepine with the benefit of hemodynamic stability, including blood pressure and pulse rate. We report a case in which remimazolam was used in living donor liver transplantation with stable hemodynamics.

Case presentation A 19-year-old woman underwent living donor liver transplantation due to end-stage liver disease, which is associated with a hyperdynamic state and hemodynamic instability. The patient’s sister had a history of malignant hyperthermia, so we chose total intravenous anesthesia with remimazolam. Intraoperative bleeding of seven liters occurred, but she had mild intraoperative blood pressure changes, and continuous catecholamine administration was not necessary. The patient had no memories or discomfort during the surgery.

Conclusions We maintained stable hemodynamics using remimazolam for anesthetic management of a patient undergoing a liver transplantation, which is characterized by a hyperdynamic state and circulatory instability.