Remimazolam in a Pediatric Patient With a Suspected Family History of Malignant Hyperthermia

Holly Petkus, Brittany L. Willer, Joseph D. Tobias


Malignant hyperthermia (MH) is an acute hypermetabolic crisis, triggered in susceptible patients by the administration of succinylcholine or a volatile anesthetic agent. When providing anesthetic care for MH-susceptible patients, a total intravenous anesthetic technique with propofol or other sedative hypnotic is frequently chosen. Remimazolam is a novel benzodiazepine which, like midazolam, has sedative, anxiolytic, and amnestic properties. Ester metabolism results in a half-life of 5-10 min and a limited context sensitive half-life. We present anecdotal experience with its use as an adjunct to propofol anesthesia in a patient with a suspected family history of MH. Previous reports of the use of remimazolam in MH-susceptible patients are reviewed and its potential role in such patients discussed.

J Med Cases. 2022;13(8):386-390


Malignant hyperthermia; Remimazolam; Total intravenous anesthesia

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