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Delayed emergence after remimazolam induction: case report A 54-yr-old man showed delayed emergence following off label use of remimazolam as an anaesthetic agent [route not stated]. The man weighing 65kg was scheduled to undergo urgent oesophagogastroduodenoscopy to evaluate haematemesis. His Child-Pugh score was 11 points: total bilirubin 3.1 mg/dL, albumin 4 mg/dL, international normalised ratio (INR) 2.3 with moderate ascites. His medical history was significant for hepatitis B cirrhosis complicated by hepatocellular carcinoma, portal hypertension, recurrent hepatic hydrothorax and ascites. Initially, he was admitted due to hyponatraemia which was complicated by hypoxic respiratory failure secondary to hepatic hydrothorax with pneumonia. Pre-procedure Hb was 6.7 g/dL, which was treated with a transfusion of one unit of packed red blood cells. Immediately before induction, blood pressure and heart rate were within normal range although he required nasal oxygen to maintain peripheral oxygen saturation at 100%. General anaesthesia was induced with lidocaine, remimazolam 0.3 mg/kg and suxamethonium. The trachea was intubated, and anaesthetic maintenance was with sevoflurane. At 40m

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Publisher

Springer Science and Business Media LLC

Published

2023

Language

EN

Field

Medicine (Health Sciences)