{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T21:10:07Z","timestamp":1756674607738,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,8,19]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>Charcot\u2013Marie\u2013Tooth (CMT) disease is a progressive hereditary neuropathy that complicates anaesthesia because of neuromuscular-blocker sensitivity. Remimazolam, an ultra-short-acting benzodiazepine, has not yet been reported in CMT. We anaesthetised a woman in her 70s with CMT type 1A and cardiac sarcoidosis for femoral nail fixation under total intravenous anaesthesia with remimazolam and remifentanil. Rocuronium 0.6\u2009mg\/kg was given 3\u2009min after induction. Mean arterial pressure ranged from \u201340% to +5% of baseline and was corrected with 6\u2009mg ephedrine. Anaesthetic depth (bispectral index) and neuromuscular block (train-of-four) were continuously monitored. The infusion was stopped at closure; she was extubated 10\u2009min later and received flumazenil 0.5\u2009mg to ensure full consciousness. No postoperative complications occurred. Remimazolam achieved acceptable haemodynamic control and rapid emergence in this first reported CMT case, suggesting it may be a valuable option for patients with neuromuscular disease and cardiac impairment.<\/jats:p>","DOI":"10.1136\/bcr-2025-267168","type":"journal-article","created":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T20:50:21Z","timestamp":1756673421000},"page":"e267168","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Anaesthetic management using remimazolam in a patient with Charcot\u2013Marie\u2013Tooth disease complicated by sarcoidosis"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6082-8203","authenticated-orcid":false,"given":"Hiroshi","family":"Kondo","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, National Hospital Organization Higashi Hiroshima Medical Center, Higashihiroshima, Hiroshima Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1734-2423","authenticated-orcid":false,"given":"Yuki","family":"Murao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Hospital Organization Higashi Hiroshima Medical Center, Higashihiroshima, Hiroshima Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0643-0316","authenticated-orcid":false,"given":"Ken","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Hospital Organization Higashi Hiroshima Medical Center, Higashihiroshima, Hiroshima Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,31]]},"reference":[{"key":"2025083113501626000_18.8.e267168.1","first-page":"607","article-title":"CMT subtypes and disease burden in patients enrolled in the Inherited Neuropathies Consortium natural history study: a cross-sectional analysis","volume":"72","author":"Fridman","year":"2015","journal-title":"JAMA Neurol"},{"key":"2025083113501626000_18.8.e267168.2","first-page":"455","article-title":"Anesthetic implications of Charcot-Marie-Tooth disease: a case report and review","volume":"20","author":"Chhabra","year":"2010","journal-title":"Middle East J Anaesthesiol"},{"key":"2025083113501626000_18.8.e267168.3","first-page":"513","article-title":"Propofol. An update of its use in anaesthesia and conscious sedation","volume":"50","author":"Bryson","year":"1995","journal-title":"Drugs (Abingdon Engl)"},{"key":"2025083113501626000_18.8.e267168.4","first-page":"625","article-title":"Remimazolam: first approval","volume":"80","author":"Keam","year":"2020","journal-title":"Drugs (Abingdon Engl)"},{"key":"2025083113501626000_18.8.e267168.5","first-page":"491","article-title":"Pharmacokinetics and pharmacodynamics of remimazolam in Japanese patients undergoing general anesthesia","volume":"34","author":"Ogawa","year":"2020","journal-title":"J Anesth"},{"key":"2025083113501626000_18.8.e267168.6","doi-asserted-by":"crossref","first-page":"1409495","DOI":"10.3389\/fmed.2025.1409495","article-title":"Comparison of the safety of remimazolam and propofol during general anesthesia in elderly patients: systematic review and meta-analysis","volume":"12","author":"Liu","year":"2025","journal-title":"Front Med"},{"key":"2025083113501626000_18.8.e267168.7","first-page":"116","article-title":"Use of midazolam in a patient with Charcot-Marie-Tooth disease: a case report","volume":"59","author":"Lee","year":"2012","journal-title":"Anesth Prog"},{"key":"2025083113501626000_18.8.e267168.8","first-page":"1033","article-title":"Clinical implications of cardiac sarcoidosis","volume":"104","author":"Mana","year":"2010","journal-title":"Respir Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-267168","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T20:50:23Z","timestamp":1756673423000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-267168"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":8,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,31]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bcr-2025-267168"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-267168","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}