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Remimazolam Requires Less Vasopressor Support during Induction and Maintenance of General Anesthesia in Patients with Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement: A Retrospective Analysis from a Single Center
- Source :
- BioMed research international. 2022
- Publication Year :
- 2022
-
Abstract
- Introduction. We compared the hemodynamics during general anesthesia with remimazolam and conventional anesthetics in patients with severe aortic stenosis (AS). Methods. This was a retrospective single-center analysis. We reviewed the records of 42 patients who underwent transcatheter aortic valve implantation with a transfemoral artery approach under general anesthesia from January to December 2020. Patients were divided into three groups based on the general anesthetic used for (induction/maintenance) remimazolam/remimazolam (Group R/R), propofol/sevoflurane (Group P/S), and midazolam/propofol (Group M/P). Vasopressor use (ephedrine, phenylephrine, and noradrenaline) was compared among the groups. Results. The number of patients in each group was 15 (Group R/R), 13 (Group P/S), and 14 (Group M/P), with no significant difference in background characteristics and intraoperative vital signs. For anesthesia induction, doses of ephedrine and phenylephrine used were significantly lower in Group R/R (ephedrine [mg]: Group R/R 2 [0–4] vs. Group P/S 8 [8–12], P < 0.001 , Group R/R vs. Group M/P 5 [0–15], P = 0.39 ; phenylephrine (mg): Group R/R 0 [0–0.08] vs. Group P/S 0.15 [0.10–0.20], P = 0.03 , Group M/P 0.21 [0.04–0.40], P = 0.08 ). For anesthesia maintenance, the noradrenaline dose used was low in the Group R/R (noradrenaline [μg/kg/min]: Group R/R 0.019 [0.015–0.039], Group P/S 0.042 [0.035–0.045], P = 0.02 , Group M/P 0.048 [0.040–0.059], P < 0.01 ). Conclusion. In patients with severe AS, induction and maintenance of anesthesia with remimazolam resulted in less overall vasopressor use than conventional general anesthetics.
- Subjects :
- Ephedrine
General Immunology and Microbiology
Article Subject
Anesthetics, General
General Medicine
Aortic Valve Stenosis
Anesthesia, General
General Biochemistry, Genetics and Molecular Biology
Transcatheter Aortic Valve Replacement
Phenylephrine
Norepinephrine
Aortic Valve
Humans
Propofol
Retrospective Studies
Subjects
Details
- ISSN :
- 23146141
- Volume :
- 2022
- Database :
- OpenAIRE
- Journal :
- BioMed research international
- Accession number :
- edsair.doi.dedup.....60d0fbc606b661a14e8e505281ea56ff