気管支拡張症患者の短期滞在手術に対するレミマゾラム全静脈麻酔の経験

Total Intravenous Anesthesia using Remimazolam for a Patient with Bronchiectasis Undergoing Short-stay Surgery：A Case Report

要旨

　気管支拡張症患者に全身麻酔下短期滞在軟部腫瘍摘出術が予定された。本疾患患者の全身麻酔では，大量喀痰による呼吸器合併症（気道閉塞，無気肺や肺感染症など）発症リスクが高く，気道管理にしばしば難渋する。本症例では，レミマゾラムを用いた全静脈麻酔を行うことで，周術期呼吸器合併症を引き起こすことなく管理できた。

　A 78-year-old woman with bronchiectasis was scheduled to undergo short-stay surgery（right flank tumor resection）under general anesthesia. Previous reports demonstrate that large amounts of sputa, which may be associated with airway obstruction, atelectasis and pulmonary infection, are excreted during general anesthesia in patients with bronchiectasis. Volatile inhaled anesthetics impair mucociliary function that may contribute to perioperative respiratory complications. Remimazolam is a newly developed, short-acting benzodiazepine that, like midazolam, probably has little cilioinhibitory effect. Remimazolam-based total intravenous anesthesia was applied for the patient’s general anesthesia, and the procedure was completed without perioperative complications.