悪性高熱症既往を強く疑う患者に対し，レミマゾラムの使用により安全に全身麻酔管理を行えた1症例

Safe Anesthetic Management with Remimazolam in a Patient with a Strongly Suspected History of Malignant Hyperthermia：A Case Report

要旨

　ロボット支援腹腔鏡下前立腺全摘除術を受ける悪性高熱症既往を強く疑う患者に対しレミマゾラムを使用し全身麻酔を行った。術中，術後ともに悪性高熱症を疑う所見を認めず，安全に麻酔を施行できた。本術式では呼気終末二酸化炭素濃度やミオグロビン尿が悪性高熱症の早期診断指標として使用し難い可能性に留意する必要がある。

　A 71-year-old man was scheduled for a robot-assisted laparoscopic radical prostatectomy（RARP）. While he had been under general anesthesia with enflurane and succinylcholine 35 years earlier, he developed remarkable increases in the levels of serum creatine kinase and myoglobin plus muscle rigidity that suggested the possibility of malignant hyperthermia（MH）. We used remimazoram, remifentanil and rocuronium for general anesthesia, and the patient’s intra-and postoperative course was uneventful. It is needed to pay attention the possibility that the EtCO₂ and urine myoglobin are difficult to use as early diagnosis indicators of a MH in a RARP. Remimazolam may be a good option for general anesthesia in patients with suspected MH.