全身麻酔導入時にレミマゾラム耐性を示したが，全身麻酔維持をレミマゾラムで行えた1症例

A Case in which Remimazolam Tolerance was Observed during Induction of General Anesthesia, but Anesthesia was Successfully Maintained with Remimazolam

要旨

　ベンゾジアゼピン長期服用患者に全身麻酔が予定された。レミマゾラム6mg・kg^－1・hr^－1で麻酔導入を開始したが，0.9mg・kg^－1で導入不完全であった。プロポフォール追加投与で導入したが，麻酔維持はレミマゾラムで可能であった。ベンゾジアゼピン耐性患者でもレミマゾラムで全身麻酔維持不可能とは必ずしもいえないことが示された。

　A 45-year-old female who had been taking benzodiazepines for a long time（＞10 years） was scheduled for urgent surgery（ventriculoperitoneal shunt catheter removal due to catheter infection）. General anesthesia induced with remimazolam at a dose of 6 mg・kg^－1・h^－1（up to 0.9 mg・kg^－1）was incomplete, indicating remimazolam tolerance. The patient became completely unresponsive after additional propofol administration, however, general anesthesia was successfully maintained with remimazolam. The patient awoke uneventfully and without delay after remimazolam discontinuation, and had no intraoperative awareness. This case suggests that it is not necessarily impossible to maintain general anesthesia with remimazolam even in patients who show benzodiazepine tolerance.