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General anesthesia with remimazolam for tooth extraction in a patient with Noonan syndrome and hypertrophic obstructive cardiomyopathy: A case report

https://hiroshima.repo.nii.ac.jp/records/2040709
https://hiroshima.repo.nii.ac.jp/records/2040709
94d401da-5ab8-4040-bc8a-fe2d17ebe368
名前 / ファイル ライセンス アクション
JOMSMP_37_1_108.docx JOMSMP_37_1_108.docx (71 KB)
Fig1.png Fig1.png (1.1 MB)
Item type デフォルト(1)
公開日 2025-06-11
タイトル
タイトル General anesthesia with remimazolam for tooth extraction in a patient with Noonan syndrome and hypertrophic obstructive cardiomyopathy: A case report
言語 en
作成者 Kamio, Hisanobu

× Kamio, Hisanobu

en Kamio, Hisanobu

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Oue, Kana

× Oue, Kana

en Oue, Kana

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Asada , Yasuyuki

× Asada , Yasuyuki

en Asada , Yasuyuki

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Ito, Nanako

× Ito, Nanako

en Ito, Nanako

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Imamura, Serika

× Imamura, Serika

en Imamura, Serika

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Doi, Mitsuru

× Doi, Mitsuru

en Doi, Mitsuru

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Shimizu, Yoshitaka

× Shimizu, Yoshitaka

en Shimizu, Yoshitaka

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Yoshida, Mitsuhiro

× Yoshida, Mitsuhiro

en Yoshida, Mitsuhiro

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Yanamoto, Souichi

× Yanamoto, Souichi

en Yanamoto, Souichi

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Hanamoto, Hiroshi

× Hanamoto, Hiroshi

en Hanamoto, Hiroshi

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アクセス権
アクセス権 open access
アクセス権URI http://purl.org/coar/access_right/c_abf2
権利情報
言語 en
権利情報 ©[ 2024]. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
権利情報
言語 en
権利情報 This is not the published version. Please cite only the published version.
権利情報
言語 ja
権利情報 この論文は出版社版ではありません。引用の際には出版社版をご確認、ご利用ください。
主題
言語 en
主題Scheme Other
主題 Noonan syndrome
主題
言語 en
主題Scheme Other
主題 Hypertrophic cardiomyopathy
主題
言語 en
主題Scheme Other
主題 Hypertrophic obstructive cardiomyopathy
主題
言語 en
主題Scheme Other
主題 Remimazolam
主題
言語 en
主題Scheme Other
主題 Noncardiac surgery
内容記述
内容記述タイプ Abstract
内容記述 Noonan syndrome (NS) is characterized by various abnormalities and is complicated with cardiac diseases, such as hypertrophic cardiomyopathy, in > 80% of cases. Minimum hemodynamic changes are a crucial factor during general anesthesia in such patients. We report the case of a patient with NS and hypertrophic obstructive cardiomyopathy (HOCM) who underwent general anesthesia using remimazolam, a new ultrashort-acting benzodiazepine anesthetic, which is expected to cause less circulatory depression. A 19-year-old woman with NS complicated with HOCM was scheduled to undergo extraction of the wisdom teeth and second molar under general anesthesia. Preoperative evaluation revealed HOCM with left ventricular outflow tract obstruction and the patient had chronic heart failure. After the placement of an arterial line under moderate sedation with remimazolam, general anesthesia was induced with remimazolam, fentanyl, and rocuronium, followed by anesthesia maintenance with remimazolam and remifentanil. Tracheal intubation was performed using videolaryngoscopy. Local anesthesia and inferior alveolar nerve block were performed using adrenaline-free local anesthetics. Intraoperatively, low-dose phenylephrine was administered continuously to maintain peripheral vascular resistance. At the end of surgery, the endotracheal tube was replaced with an i-gel® supraglottic airway device before emergence from general anesthesia. After full recovery from anesthesia, the i-gel® was removed, and the patient was transferred to the hospital ward. The perioperative blood pressure and heart rate were maintained within normal ranges, and no cardiovascular events occurred during anesthesia. Anesthesia management using remimazolam and low-dose phenylephrine with reduction in perioperative stress may provide an appropriate circulatory condition for noncardiac surgery in patients with HOCM.
言語 en
出版者
出版者 Elsevier
言語 en
言語
言語 eng
資源タイプ
資源タイプ識別子 http://purl.org/coar/resource_type/c_6501
資源タイプ journal article
出版タイプ
出版タイプ AM
出版タイプResource http://purl.org/coar/version/c_ab4af688f83e57aa
関連情報
関連タイプ isVersionOf
識別子タイプ DOI
関連識別子 https://doi.org/10.1016/j.ajoms.2024.04.016
収録物識別子
収録物識別子タイプ ISSN
収録物識別子 2212-5558
書誌情報 en : JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY

巻 37, 号 1, p. 108-111, 発行日 2024-05-02
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