Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 13, Number 10, October 2022, pages 495-498

Remimazolam for Sedation During Upper Gastrointestinal Endoscopy in an Adolescent

Table

Table 1. Previous Reports of Remimazolam Administration in Pediatric-Aged Patients
 
Authors and citationClinical scenarioRemimazolam dosing and outcomes
Horikoshi et al, 2021 [16]4-year, 16 kg boy for laparoscopic herniorrhaphy, diagnosed with Duchenne muscular dystrophy due to elevated creatine phosphokinaseAnesthesia was induced with remimazolam (3 mg) and fentanyl (100 µg) followed by infusions of remifentanil (1 µg/kg/min) and remimazolam (15 mg/h). Neuromuscular blockade was provided by rocuronium followed by sugammadex for reversal at the completion of the procedure. The remimazolam infusion was reduced to 5 mg/h, 30 min prior to the end of the surgery. Emergence from anesthesia was slightly prolonged (20 min). Postoperative course was uncomplicated.
Kamata et al, 2022 [17]12-year-old, 55 kg adolescent for brain tumor resection with cortical motor-evoked potential (MEP) monitoringRemimazolam chosen instead of propofol, due to the patient’s egg hypersensitivity. General anesthesia was induced with remimazolam at 6 mg/kg/h and remifentanil at 0.5 µg/kg/min. After loss of consciousness, remimazolam infusion was reduced to 1.5 mg/kg/h and rocuronium administered to facilitate endotracheal intubation. Neither additional rocuronium nor sugammadex was administered during MEP monitoring. Adequate maintenance anesthesia with MEP monitoring with infusions of remimazolam (0.9 - 1.5 mg/kg/h) and remifentanil (0.3 - 0.4 µg/kg/min).
Petkus et al, 2022 [18]6-year-old, 24 kg girl with a family history of malignant hyperthermiaRemimazolam (5 - 7 µg/kg/min) administered as an adjunct to propofol (50 µg/kg/min) for maintenance anesthesia during dental surgery. Analgesia was provided by morphine (1 mg) and ketorolac (0.5 mg/kg). No intraoperative concerns were noted, and recovery was rapid.