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e-Article

General anesthesia with remimazolam for a pediatric patient with MELAS and recurrent epilepsy: a case report
Document Type
article
Source
JA Clinical Reports, Vol 8, Iss 1, Pp 1-4 (2022)
Subject
MELAS
Mitochondrial Encephalomyopathy
Remimazolam
General anesthesia
Epilepsy
Epileptic seizure
Anesthesiology
RD78.3-87.3
Medical emergencies. Critical care. Intensive care. First aid
RC86-88.9
Language
English
ISSN
2363-9024
Abstract
Abstract Background Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) is a mitochondrial disease. We report here the safe use of remimazolam in a pediatric MELAS patient. Case presentation A 10-year-old girl (118 cm, 16 kg) was scheduled for an open gastrostomy to improve nutrition and epileptic seizure control. We induced and maintained general anesthesia with remimazolam, remifentanil, fentanyl, and rocuronium. We also performed a bilateral subcostal transversus abdominis plane block before the surgery. The surgery finished uneventfully. After we discontinued remimazolam administration, the patient woke up immediately but calmly without flumazenil. Epileptic seizures did not occur during intra- and early post-operative periods. Conclusion Remimazolam enabled us to provide a pediatric MELAS patient with general anesthesia without causing delayed emergence or epileptic seizures.