{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:32:38Z","timestamp":1782603158278,"version":"3.54.5"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>There is currently limited research on the clinical use of remimazolam in severely obese patients. In this report, we describe the anesthesia management of transcatheter aortic valve implantation (TAVI) in a severely obese patient using remimazolam.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case description<\/jats:title>\n                <jats:p>A 76-year-old woman (height 1.54\u00a0m; total body weight 104\u00a0kg; body mass index 43.9\u00a0kg\/m<jats:sup>2<\/jats:sup>) was scheduled for TAVI via the femoral artery approach for aortic valve stenosis. Preoperative echocardiography showed an aortic valve peak flow of 4.0\u00a0m\/s and an effective orifice area of 0.75\u00a0cm<jats:sup>2<\/jats:sup>. Anesthesia induction was performed with a bolus dose of 100\u00a0\u03bcg fentanyl, 15\u00a0mg remimazolam, 60\u00a0mg rocuronium, and a continuous infusion of remifentanil at 0.4\u00a0mg\/h. Intraoperatively, remimazolam was administered at a rate of 35\u00a0mg\/h. General anesthesia management was completed without any complications, although the patient required temporary catecholamine and inhalation anesthesia assistance due to hemodynamic changes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Owing to its pharmacological advantages, remimazolam may be an option for anesthesia induction and maintenance in severely obese patients with unstable circulation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40981-024-00716-1","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T02:01:58Z","timestamp":1716775318000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Remimazolam for general anesthesia in a patient with aortic stenosis and severe obesity undergoing transcatheter aortic valve implantation"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0986-3446","authenticated-orcid":false,"given":"Atsushi","family":"Kainuma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Koyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao","family":"Kinoshita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Iida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teiji","family":"Sawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,27]]},"reference":[{"key":"716_CR1","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1097\/01.anes.0000267503.85085.c0","volume":"107","author":"GJ Kilpatrick","year":"2007","unstructured":"Kilpatrick GJ, McIntyre MS, Cox RF, et al. CNS 7056: a novel ultra-short-acting Benzodiazepine. Anesthesiology. 2007;107:60\u20136.","journal-title":"Anesthesiology"},{"key":"716_CR2","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1213\/ANE.0b013e31823f0c28","volume":"115","author":"LJ Antonik","year":"2012","unstructured":"Antonik LJ, Goldwater DR, Kilpatrick GJ, et al. A placebo- and midazolam-controlled phase I single ascending-dose study evaluating the safety, pharmacokinetics, and pharmacodynamics of remimazolam (CNS 7056): Part I. Safety, efficacy, and basic pharmacokinetics. Anesth Analg. 2012;115:274\u201383.","journal-title":"Anesth Analg."},{"key":"716_CR3","doi-asserted-by":"publisher","first-page":"3957","DOI":"10.2147\/DDDT.S384155","volume":"16","author":"Q Hu","year":"2022","unstructured":"Hu Q, Liu X, Wen C, et al. Remimazolam: an updated review of a new sedative and anaesthetic. Drug Des Devel Ther. 2022;16:3957\u201374.","journal-title":"Drug Des Devel Ther"},{"key":"716_CR4","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.3390\/medicina59071247","volume":"59","author":"SH Lee","year":"2023","unstructured":"Lee SH, Han H. Remimazolam induction in a patient with super-super obesity and obstructive sleep apnea: a case report. Medicina (Kaunas). 2023;59:1247.","journal-title":"Medicina (Kaunas)"},{"key":"716_CR5","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1007\/s00540-022-03079-y","volume":"36","author":"K Masui","year":"2022","unstructured":"Masui K, St\u00f6hr T, Pesic M, et al. A population pharmacokinetic model of remimazolam for general anesthesia and consideration of remimazolam dose in clinical practice. J Anesth. 2022;36:493\u2013505.","journal-title":"J Anesth"},{"key":"716_CR6","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.bja.2022.02.040","volume":"129","author":"D Chae","year":"2022","unstructured":"Chae D, Kim HC, Song Y, et al. Pharmacodynamic analysis of intravenous bolus remimazolam for loss of consciousness in patients undergoing general anaesthesia: a randomised, prospective, double-blind study. Br J Anaesth. 2022;129:49\u201357.","journal-title":"Br J Anaesth"},{"key":"716_CR7","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1007\/s00540-020-02776-w","volume":"34","author":"M Doi","year":"2020","unstructured":"Doi M, Hirata N, Suzuki T, et al. Safety and efficacy of remimazolam in induction and maintenance of general anesthesia in high-risk surgical patients (ASA Class III): results of a multicenter, randomized, double-blind, parallel-group comparative trial. J Anesth. 2020;34:491\u2013501.","journal-title":"J Anesth."},{"issue":"1","key":"716_CR8","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/s12871-022-01641-5","volume":"22","author":"J Zhang","year":"2022","unstructured":"Zhang J, Wang X, Zhang Q, et al. Application effects of remimazolam and propofol on elderly patients undergoing hip replacement. BMC Anesthesiol. 2022;22(1):118.","journal-title":"BMC Anesthesiol"},{"key":"716_CR9","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1177\/0269881117714050","volume":"31","author":"S Tamburin","year":"2017","unstructured":"Tamburin S, Faccini M, Casari R, et al. Low risk of seizures with slow flumazenil infusion and routine anticonvulsant prophylaxis for high-dose benzodiazepine dependence. 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J Anesth. 2022;36(2):194\u2013200.","journal-title":"J Anesth"}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-024-00716-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-024-00716-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-024-00716-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T02:04:54Z","timestamp":1716775494000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-024-00716-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,27]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["716"],"URL":"https:\/\/doi.org\/10.1186\/s40981-024-00716-1","relation":{},"ISSN":["2363-9024"],"issn-type":[{"value":"2363-9024","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,27]]},"assertion":[{"value":"28 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 May 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2024","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"In our hospital, the publication of case reports is exempted from ethics committee approval.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent was obtained from the patient for publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"34"}}