{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:40:22Z","timestamp":1774622422656,"version":"3.50.1"},"reference-count":20,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:p>Remimazolam, an ultra-short-acting benzodiazepine, is a new intravenous anesthetic used for sedation and general anesthesia. Because remimazolam is primarily metabolized by carboxylesterases in the liver and other tissues including the lung and has metabolites with little or no bioactivity, its anesthetic effect is not significantly influenced by renal dysfunction. Therefore, remimazolam may be considered an appropriate agent for hemodialysis patients and may have added benefits beyond midazolam and propofol. Remimazolam has also been suggested to cause less cardiac depression than propofol. This case report presents an 82-year-old female hemodialysis patient with chronic heart failure who underwent partial glossectomy for squamous cell carcinoma of the tongue under general anesthesia with remimazolam and remifentanil. Hemodynamic control was stable during the anesthetic, which was safely completed without any adverse events and resulted in a rapid, clear emergence without flumazenil. Remimazolam and remifentanil may be appropriate as first-line general anesthetic agents for hemodialysis patients with heart failure.<\/jats:p>","DOI":"10.2344\/anpr-70-02-06","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T14:57:03Z","timestamp":1687964223000},"page":"65-69","source":"Crossref","is-referenced-by-count":9,"title":["Anesthetic Management Using Remimazolam in a Hemodialysis Patient"],"prefix":"10.2344","volume":"70","author":[{"given":"Yukiko","family":"Nishioka","sequence":"first","affiliation":[{"name":"*Department of Dental Anesthesiology, Okayama University Hospital, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saki","family":"Miyake","sequence":"additional","affiliation":[{"name":"\u2020Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Midori","family":"Hamaoka","sequence":"additional","affiliation":[{"name":"\u2020Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kota","family":"Miyake","sequence":"additional","affiliation":[{"name":"\u2020Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maki","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"*Department of Dental Anesthesiology, Okayama University Hospital, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Higuchi","sequence":"additional","affiliation":[{"name":"*Department of Dental Anesthesiology, Okayama University Hospital, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Miyawaki","sequence":"additional","affiliation":[{"name":"\u2020Department of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1191","published-online":{"date-parts":[[2023,6,28]]},"reference":[{"key":"2023062814560445000_i1878-7177-70-2-65-b01","doi-asserted-by":"crossref","unstructured":"Kilpatrick\n              GJ,\n            \n            \n              Mclntyre\n              MS,\n            \n            \n              Cox\n              RF,\n            \n            et al.\n          \n          CNS 7056: a novel ultra-short-acting benzodiazepine.\n\t\t\t\t\tAnesthesiology.\n\t\t\t\t\t2007;\n\t\t\t\t\t107:\n\t\t\t\t\t60\u2013\n\t\t\t\t\t66.","DOI":"10.1097\/01.anes.0000267503.85085.c0"},{"key":"2023062814560445000_i1878-7177-70-2-65-b02","doi-asserted-by":"crossref","unstructured":"Schuttler\n              J,\n            \n            \n              Eisenried\n              A,\n            \n            \n              Lerch\n              M,\n            \n            \n              Fechner\n              J,\n            \n            \n              Jeleazcov\n              C,\n            \n            \n              Ihmsen\n              H.\n            \n          \n          Pharmacokinetics and pharmacodynamics of remimazolam (CNS 7056) after continuous infusion in healthy male volunteers: part I. pharmacokinetics and clinical pharmacodynamics.\n\t\t\t\t\tAnesthesiology.\n\t\t\t\t\t2020;\n\t\t\t\t\t132:\n\t\t\t\t\t636\u2013\n\t\t\t\t\t651.","DOI":"10.1097\/ALN.0000000000003103"},{"key":"2023062814560445000_i1878-7177-70-2-65-b03","doi-asserted-by":"crossref","unstructured":"Doi\n              M,\n            \n            \n              Hirata\n              N,\n            \n            \n              Suzuki\n              T,\n            \n            \n              Morisaki\n              H,\n            \n            \n              Morimatsu\n              H,\n            \n            \n              Sakamoto\n              A.\n            \n          \n          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.\n\t\t\t\t\tJ Anesth.\n\t\t\t\t\t2020;\n\t\t\t\t\t34:\n\t\t\t\t\t491\u2013\n\t\t\t\t\t501.","DOI":"10.1007\/s00540-020-02776-w"},{"key":"2023062814560445000_i1878-7177-70-2-65-b04","doi-asserted-by":"crossref","unstructured":"Doi\n              M,\n            \n            \n              Morita\n              K,\n            \n            \n              Takeda\n              J,\n            \n            \n              Sakamoto\n              A,\n            \n            \n              Yamakage\n              M,\n            \n            \n              Suzuki\n              T.\n            \n          \n          Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase IIb\/III trial.\n\t\t\t\t\tJ Anesth.\n\t\t\t\t\t2020;\n\t\t\t\t\t34:\n\t\t\t\t\t543\u2013\n\t\t\t\t\t553.","DOI":"10.1007\/s00540-020-02788-6"},{"key":"2023062814560445000_i1878-7177-70-2-65-b05","doi-asserted-by":"crossref","unstructured":"Masui\n              K.\n            \n          \n          Remimazolam besilate, a benzodiazepine, has been approved for general anesthesia!!\n          \n            J Anesth\n          .\n\t\t\t\t\t2020;\n\t\t\t\t\t34:\n\t\t\t\t\t479\u2013\n\t\t\t\t\t482.","DOI":"10.1007\/s00540-020-02755-1"},{"key":"2023062814560445000_i1878-7177-70-2-65-b06","doi-asserted-by":"crossref","unstructured":"Nagueh\n              SF,\n            \n            \n              Smiseth\n              OA,\n            \n            \n              Appleton\n              CP,\n            \n            et al.\n          \n          Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.\n\t\t\t\t\tJ Am Soc Echocardiogr.\n\t\t\t\t\t2016;\n\t\t\t\t\t29:\n\t\t\t\t\t277\u2013\n\t\t\t\t\t314.","DOI":"10.1016\/j.echo.2016.01.011"},{"key":"2023062814560445000_i1878-7177-70-2-65-b07","doi-asserted-by":"crossref","unstructured":"Kanda\n              H,\n            \n            \n              Hirasaki\n              Y,\n            \n            \n              Iida\n              T,\n            \n            et al.\n          \n          Perioperative management of patients with end-stage renal disease.\n\t\t\t\t\tJ Cardiothorac Vasc Anesth.\n\t\t\t\t\t2017;\n\t\t\t\t\t31:\n\t\t\t\t\t2251\u2013\n\t\t\t\t\t2267.","DOI":"10.1053\/j.jvca.2017.04.019"},{"key":"2023062814560445000_i1878-7177-70-2-65-b08","doi-asserted-by":"crossref","unstructured":"Gajdos\n              C,\n            \n            \n              Hawn\n              MT,\n            \n            \n              Kile\n              D,\n            \n            \n              Robinson\n              TN,\n            \n            \n              Henderson\n              WG.\n            \n          \n          Risk of major nonemergent inpatient general surgical procedures in patients on long-term dialysis.\n\t\t\t\t\tJAMA Surg.\n\t\t\t\t\t2013;\n\t\t\t\t\t148:\n\t\t\t\t\t137\u2013\n\t\t\t\t\t143.","DOI":"10.1001\/2013.jamasurg.347"},{"key":"2023062814560445000_i1878-7177-70-2-65-b09","doi-asserted-by":"crossref","unstructured":"Kilpatrick\n              GJ.\n            \n          \n          Remimazolam: non-clinical and clinical profile of a new sedative\/anesthetic agent.\n\t\t\t\t\tFront Pharmacol.\n\t\t\t\t\t2021;\n\t\t\t\t\t12:\n\t\t\t\t\t690875.","DOI":"10.3389\/fphar.2021.690875"},{"key":"2023062814560445000_i1878-7177-70-2-65-b10","doi-asserted-by":"crossref","unstructured":"Stohr\n              T,\n            \n            \n              Colin\n              PJ,\n            \n            \n              Ossig\n              J,\n            \n            et al.\n          \n          Pharmacokinetic properties of remimazolam in subjects with hepatic or renal impairment.\n\t\t\t\t\tBr J Anaesth.\n\t\t\t\t\t2021;\n\t\t\t\t\t127:\n\t\t\t\t\t415\u2013\n\t\t\t\t\t423.","DOI":"10.1016\/j.bja.2021.05.027"},{"key":"2023062814560445000_i1878-7177-70-2-65-b11","doi-asserted-by":"crossref","unstructured":"Antonik\n              LJ,\n            \n            \n              Goldwater\n              DR,\n            \n            \n              Kilpatrick\n              GJ,\n            \n            \n              Tilbrook\n              GS,\n            \n            \n              Borkett\n              KM.\n            \n          \n          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.\n\t\t\t\t\tAnesth Analg.\n\t\t\t\t\t2012;\n\t\t\t\t\t115:\n\t\t\t\t\t274\u2013\n\t\t\t\t\t283.","DOI":"10.1213\/ANE.0b013e31823f0c28"},{"key":"2023062814560445000_i1878-7177-70-2-65-b12","doi-asserted-by":"crossref","unstructured":"Vinik\n              HR,\n            \n            \n              Reves\n              JG,\n            \n            \n              Greenblatt\n              DJ,\n            \n            \n              Abernethy\n              DR,\n            \n            \n              Smith\n              LR.\n            \n          \n          The pharmacokinetics of midazolam in chronic renal failure patients.\n\t\t\t\t\tAnesthesiology.\n\t\t\t\t\t1983;\n\t\t\t\t\t59:\n\t\t\t\t\t390\u2013\n\t\t\t\t\t394.","DOI":"10.1097\/00000542-198311000-00005"},{"key":"2023062814560445000_i1878-7177-70-2-65-b13","doi-asserted-by":"crossref","unstructured":"Mandona\n              JW,\n            \n            \n              Tuk\n              B,\n            \n            \n              Van Steveninck\n              AL,\n            \n            \n              Breimer\n              DD,\n            \n            \n              Cohen\n              AF,\n            \n            \n              Danhof\n              M.\n            \n          \n          Pharmacokinetic-pharmacodynamic modeling of the central nervous system effects of midazolam and its main metabolite a-hydroxymidazolam in healthy volunteers.\n\t\t\t\t\tClin Pharmacol Ther.\n\t\t\t\t\t1992;\n\t\t\t\t\t51:\n\t\t\t\t\t715\u2013\n\t\t\t\t\t728.","DOI":"10.1038\/clpt.1992.84"},{"key":"2023062814560445000_i1878-7177-70-2-65-b14","doi-asserted-by":"crossref","unstructured":"Zaporowska-Stachowiak\n              I,\n            \n            \n              Szyma\u0144ski\n              K,\n            \n            \n              Oduah\n              MT,\n            \n            \n              Stachowiak-Szymczak,\n              \u0141uczak J,\n            \n            \n              Sopata\n              M.\n            \n          \n          Midazolam: safety of use in palliative care: a systematic critical review.\n\t\t\t\t\tBiomed Pharmacother.\n\t\t\t\t\t2019;\n\t\t\t\t\t114:\n\t\t\t\t\t108838.","DOI":"10.1016\/j.biopha.2019.108838"},{"key":"2023062814560445000_i1878-7177-70-2-65-b15","doi-asserted-by":"crossref","unstructured":"Vanlersberghe\n              C,\n            \n            \n              Camu\n              F.\n            \n          \n          Propofol.\n\t\t\t\t\tIn:Sch\u00fcttlerJ,SchwildenH.Modern Anesthetics (Handbook of Experimental Pharmacology).\n\t\t\t\t\tBerlin:\n\t\t\t\t\tSpringer;2008:\n\t\t\t\t\t227\u2013\n\t\t\t\t\t252.","DOI":"10.1007\/978-3-540-74806-9_11"},{"key":"2023062814560445000_i1878-7177-70-2-65-b16","doi-asserted-by":"crossref","unstructured":"Takizawa\n              D,\n            \n            \n              Hiraoka\n              H,\n            \n            \n              Goto\n              F,\n            \n            \n              Yamamoto\n              K,\n            \n            \n              Horiuchi\n              R.\n            \n          \n          Human kidneys play an important role in the elimination of propofol.\n\t\t\t\t\tAnesthesiology.\n\t\t\t\t\t2005;\n\t\t\t\t\t102:\n\t\t\t\t\t327\u2013\n\t\t\t\t\t330.","DOI":"10.1097\/00000542-200502000-00014"},{"key":"2023062814560445000_i1878-7177-70-2-65-b17","doi-asserted-by":"crossref","unstructured":"Ickx\n              B,\n            \n            \n              Cockshott\n              ID,\n            \n            \n              Barvais\n              L,\n            \n            et al.\n          \n          Propofol infusion for induction and maintenance of anaesthesia in patients with end-stage renal disease.\n\t\t\t\t\tBr Jr Anaesth.\n\t\t\t\t\t1998;\n\t\t\t\t\t81:\n\t\t\t\t\t854\u2013\n\t\t\t\t\t860.","DOI":"10.1093\/bja\/81.6.854"},{"key":"2023062814560445000_i1878-7177-70-2-65-b18","doi-asserted-by":"crossref","unstructured":"Coetzee\n              A,\n            \n            \n              Fourie\n              P,\n            \n            \n              Coetzee\n              J,\n            \n            et al.\n          \n          Effects of various propofol plasma concentrations on regional myocardial contractility and left ventricular afterload.\n\t\t\t\t\tAnesth Analg.\n\t\t\t\t\t1989;\n\t\t\t\t\t69:\n\t\t\t\t\t473\u2013\n\t\t\t\t\t483.","DOI":"10.1213\/00000539-198910000-00009"},{"key":"2023062814560445000_i1878-7177-70-2-65-b19","doi-asserted-by":"crossref","unstructured":"Liu\n              T,\n            \n            \n              Lai\n              T,\n            \n            \n              Chen\n              J,\n            \n            et al.\n          \n          Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: a randomized, double-blind, controlled trial.\n\t\t\t\t\tPharmacol Res Perspect.\n\t\t\t\t\t2021;\n\t\t\t\t\t9:\n\t\t\t\t\te00851.","DOI":"10.1002\/prp2.851"},{"key":"2023062814560445000_i1878-7177-70-2-65-b20","doi-asserted-by":"crossref","unstructured":"Satoh\n              T,\n            \n            \n              Nishihara\n              N,\n            \n            \n              Sawashita\n              Y,\n            \n            \n              Ohno\n              S,\n            \n            \n              Hirata\n              N,\n            \n            \n              Yamakage\n              M.\n            \n          \n          Remimazolam anesthesia for mitraClip implantation in a patient with advanced heart failure.\n\t\t\t\t\tCase Rep Anesthesiol.\n\t\t\t\t\t2021;\n\t\t\t\t\t2021:\n\t\t\t\t\t5536442.","DOI":"10.1155\/2021\/5536442"}],"container-title":["Anesthesia Progress"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/70\/2\/65\/3230206\/i1878-7177-70-2-65.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/70\/2\/65\/3230206\/i1878-7177-70-2-65.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T19:51:22Z","timestamp":1705607482000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/70\/2\/article-p65.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,1]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,6,28]]},"published-print":{"date-parts":[[2023,6,1]]}},"URL":"https:\/\/doi.org\/10.2344\/anpr-70-02-06","relation":{},"ISSN":["1878-7177","0003-3006"],"issn-type":[{"value":"1878-7177","type":"electronic"},{"value":"0003-3006","type":"print"}],"subject":[],"published":{"date-parts":[[2023,6,1]]}}}