筋萎縮性側索硬化症患者に対するレミマゾラムの使用経験

The Use of Remimazolam for General Anesthesia in a Patient with Amyotrophic Lateral Sclerosis

要旨

　筋萎縮性側索硬化症患者の四肢骨折に対して，全身麻酔下での手術が予定された。レミマゾラムは拮抗薬のある短時間作用型の麻酔薬であり，速やかな覚醒が期待できる。今回，術後の呼吸抑制を回避するため，レミマゾラムを使用し麻酔管理をした。覚醒は良好で，術後呼吸抑制を来すことなく管理することができた。

　Remimazolam, a short-acting anesthetic that contains the antagonist flumazenil, helps patients recover immediately from anesthesia. Patients can be awakened by an antagonist despite delayed awakening from anesthesia. We describe the case of a 75-year-old Japanese man with amyotrophic lateral sclerosis who was scheduled for open reduction and internal fixation of his radius and tibia under general anesthesia. We administered remimazolam for anesthetic management；muscle relaxants and long-acting opioids were not used. Flumazenil was administered after the patient’s awakening. He experienced no postoperative respiratory depression after waking. His case demonstrates that remimazolam is useful in cases in which postoperative respiratory depression should be avoided.