The intraoperative motor-evoked potential when propofol was changed to remimazolam during general anesthesia: a case series
The intraoperative motor-evoked potential when propofol was changed to remimazolam during general anesthesia: a case series
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全身麻醉期间异丙酚改为瑞马唑仑时的术中运动诱发电位：病例系列
DOI：
10.1007/s00540-022-03112-0
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发表时间：
2022
期刊：
影响因子：
2.8
通讯作者：
Mikuni N.
中科院分区：
文献类型：
--
作者：
amada S;Akiyama Y;Tachibana S;Hayamizu K;Kimura Y;Hashimoto S;Yamakage M;Mikuni N.
雷咪唑仑是一种短效苯二氮卓类药物，于2020年获准临床使用。我们报告三位接受脑部及脊髓肿瘤手术的病人，在雷米唑仑全麻下，成功地监测到经颅电刺激-运动诱发电位(TES-MEP)。异丙酚靶控浓度为2.7min、3.5min，瑞芬太尼0.35g/kg/ − 全凭静脉麻醉时，3例患者均出现苏醒延迟、心动过缓、低血压等并发症。考虑到患者的安全是最重要的，我们考虑更换麻醉剂。异丙酚的负荷量为12 mg/kg/h，持续几秒钟(例3)，然后以1 mg/kg/h的负荷量维持(例1-3)。三名患者均在异丙酚和瑞马唑仑用药期间记录TES-MEP。异丙酚和瑞咪唑仑麻醉时TES-MEP波幅依次为461.5 ± 150和590.5 ± 100.9 ，1542 ± 127和1698 ± 211，病例1的TES-MEP波幅依次为581.5 ± 91.3和634 ± 82.7µV。
Remimazolam is a short-acting benzodiazepine that was approved for clinical use in 2020. We report three patients who underwent surgery for cerebral and spinal cord tumors, in whom transcranial electrical stimulation-motor-evoked potential (TES-MEP) was successfully monitored under general anesthesia with remimazolam. During total intravenous anesthesia with propofol at a target concentration of 2.7 − 3.5 µg/mL and 0.1 − 0.35 µg/kg/min of remifentanil, delayed awakening, bradycardia, and hypotension during propofol anesthesia were expected in all three cases. With patient safety as the top priority, we considered changing the anesthetic agent. Propofol was replaced with remimazolam at a loading dose of 12 mg/kg/h for a few seconds (case 3), followed by 1 mg/kg/h for maintenance (cases 1–3). TES-MEP was recorded during propofol and remimazolam administration in all three patients. Amplitudes of TES-MEP during anesthesia with propofol and remimazolam were 461.5 ± 150 µV and 590.5 ± 100.9 µV, 1542 ± 127 µV and 1698 ± 211 µV, and 581.5 ± 91.3 µV and 634 ± 82.7 µV sequentially from Case 1. Our findings suggest that intraoperative TES-MEP could be measured when anesthesia was managed with remimazolam at 1 mg/kg/h.
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影响因子：
--
作者：
R. Penney
通讯作者：
R. Penney
影响因子：
8.8
作者：
KALKMAN, CJ;DRUMMOND, JC;BICKFORD, RG
通讯作者：
BICKFORD, RG
影响因子：
3
作者：
Walker, Corey T.;Kim, Han Jo;Uribe, Juan S.
通讯作者：
Uribe, Juan S.
影响因子：
4.8
作者：
TANIGUCHI, M;CEDZICH, C;FRIEDMAN, WA
通讯作者：
FRIEDMAN, WA