人工膝関節全置換術を受ける高度肥満を有する統合失調症患者のレミマゾラムを用いた全身麻酔の経験

General Anesthesia with Remimazolam for a Patient with Schizophrenia and Morbid Obesity Undergoing a Total Knee Arthroplasty：A Case Report

要旨

　統合失調症患者や高度肥満患者では種々の周術期合併症リスク（前者では低血圧，不整脈，術後せん妄，覚醒遅延，悪性症候群など，後者では困難気道，呼吸循環不安定など）が高い。高度肥満を有する統合失調症患者の人工膝関節全置換術をレミマゾラムを用いた全身麻酔で行い，重大有害事象を引き起こすことなく管理できた。

　Patients with schizophrenia and morbid obesity are at a high risk of various types of perioperative complications such as hypotension, arrhythmia, delayed emergence, postoperative delirium, and neuroleptic malignant syndrome in patients with schizophrenia, and difficult airway and cardiopulmonary instability in those with morbid obesity. In the case described herein, remimazolam was used for the general anesthesia during a total knee arthroplasty for a 42-year-old female patient with both schizophrenia and morbid obesity. Her perioperative course was uneventful and involved no serious adverse events, including neuropsychiatric and cardiopulmonary complications. This case indicates that remimazolam can be a good option as a general anesthetic for patients with schizophrenia and morbid obesity.