Affiliation:
1. Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan 49201, Republic of Korea
Abstract
Remimazolam is a benzodiazepine with rapid onset and recovery time. Ketamine provides analgesia and sedation without compromising hemodynamics. Combining both agents may provide good anesthesia and analgesia with fewer complications. We report four cases of monitored anesthesia care with a combination of remimazolam and ketamine for brief gynecological surgeries. We applied 0.5 mg/kg bolus ketamine and infused patients with remimazolam at 6 mg/kg/h for induction and 1 mg/kg/h for maintenance. Then, 25 µg of fentanyl was administered for analgesia 4 min before the procedure, and additional fentanyl was administered as needed. Remimazolam was discontinued shortly after surgery. We conducted satisfactory monitored anesthesia care with a combination of remimazolam and ketamine in all four cases.
Reference10 articles.
1. A phase IIb study comparing the safety and efficacy of remimazolam and midazolam in patients undergoing colonoscopy;Pambianco;Gastrointest. Endosc.,2016
2. Remimazolam: Pharmacological characteristics and clinical applications in anesthesiology;Kim;Anesth. Pain Med.,2022
3. Efficacy and safety of remimazolam versus propofol for general anesthesia: A multicenter, single-blind, randomized, parallel-group, phase Iib/III trial;Doi;J. Anesth.,2020
4. Gales, A., and Maxwell, S. (2018). Ketamine: Recent evidence and current uses. Updat. Anaesth., 43–48. Available online: https://www.wfsahq.org/resources/update-in-anaesthesia.
5. A combination of midazolam and ketamine for procedural sedation and analgesia in adult emergency department patients;Chudnofsky;Acad. Emerg. Med.,2000