低心機能患者の短期滞在鼠径ヘルニア手術に対するレミマゾラムを用いた全身麻酔の経験

Anesthetic Management using Remimazolam for Short-stay Open Inguinal Hernia Surgery in a Patient with a Reduced Ejection Fraction：A Case Report

要旨

　低心機能患者（左室駆出率35％）の短期滞在鼠径ヘルニア手術を腸骨鼠径・腸骨下腹神経ブロック併用レミマゾラム全身麻酔で管理した。術中，軽度低血圧と唾液分泌過剰を生じたが，重篤な合併症を起こすことなく管理できた。循環抑制作用の少ないレミマゾラムは低心機能患者の短期滞在手術に良い選択肢となる可能性がある。

　A 72-year-old man with a low（35％）left ventricular ejection fraction underwent short-stay open inguinal hernia surgery under general anesthesia using remimazolam coupled with an ilioinguinal-iliohypogastric nerve block. Remimazolam is a newly developed short-acting benzodiazepine that exerts a lesser cardiovascular effect compared to classical general anesthetics. Although transient intraoperative hypotension treated with phenylephrine and excessive salivary excretion occurred during the patient’s surgery, the procedure was completed without the development of any significant perioperative complication. Remimazolam can be a candidate general anesthetic for patients with low cardiac function undergoing short-stay surgery.