{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T01:22:15Z","timestamp":1787966535457,"version":"build-2784847793"},"reference-count":14,"publisher":"The Korean Society of Anesthesiologists","issue":"4","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["anesth-pain-med.org"],"crossmark-restriction":true},"short-container-title":["Anesth Pain Med"],"published-print":{"date-parts":[[2024,10,31]]},"abstract":"<jats:p>Background: Remimazolam, an ultra-short-acting anesthetic with flumazenil as a reversal agent, typically facilitates patient awakening postoperative. However, our case reveals an unusual occurrence: despite flumazenil initially restoring consciousness, re-sedation due to remimazolam ensued six hours later.Case: A 65-year-old woman underwent total intravenous general anesthesia with remimazolam and remifentanil during the 140-min surgery. Despite an initially smooth recovery, she progressively became drowsy upon transfer to the general ward, eventually reaching a stuporous state. Multiple interventions, including opioid reversal (intravenous patient-controlled analgesia discontinuation and naloxone administration), were attempted. Neurological consultation revealed no issues; however, immediate improvement after flumazenil administration suggested remimazolam's involvement. The patient was discharged without complications.Conclusions: This case challenges our understanding of remimazolam's dynamics, emphasizing the necessity for vigilant post-anesthesia monitoring, even in seemingly low-risk cases. It advocates for standardized response protocols to promptly manage unforeseen events and ensure patient safety.<\/jats:p>","DOI":"10.17085\/apm.24009","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T04:37:38Z","timestamp":1730695058000},"page":"320-325","update-policy":"https:\/\/doi.org\/10.17085\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Case report of atypical re-sedation after general anesthesia using remimazolam"],"prefix":"10.17085","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3003-2834","authenticated-orcid":true,"given":"Soo Jee","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0848-0276","authenticated-orcid":true,"given":"Insik","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7119-0698","authenticated-orcid":true,"given":"Seongmin","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1792-3771","authenticated-orcid":true,"given":"Seunghee","family":"Ki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2573","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003103"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1186\/s40981-022-00590-9"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.05.027"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.09.006"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-022-03107-x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-021-02915-x"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-37150-9"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200111000-00019"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1806"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-021-02930-y"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1194"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1097\/meg.0000000000002201"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1186\/s40981-022-00584-7"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1186\/s40981-022-00576-7"}],"container-title":["Anesthesia and Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/anesth-pain-med.org\/upload\/pdf\/apm-24009.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/anesth-pain-med.org\/journal\/view.php?doi=10.17085\/apm.24009","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/anesth-pain-med.org\/upload\/pdf\/apm-24009.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T06:40:30Z","timestamp":1730702430000},"score":1,"resource":{"primary":{"URL":"http:\/\/anesth-pain-med.org\/journal\/view.php?doi=10.17085\/apm.24009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,31]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,10]]}},"URL":"https:\/\/doi.org\/10.17085\/apm.24009","relation":{},"ISSN":["1975-5171","2383-7977"],"issn-type":[{"value":"1975-5171","type":"print"},{"value":"2383-7977","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,31]]},"assertion":[{"value":"2024-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-25","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-31","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}