Management of pneumonectomy in an adult congenital heart disease with Fontan circulation under general anesthesia with remimazolam: A case report

  • Funatsu Yasutaka
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital
  • Shirozu Kazuhiro
    Operating Rooms, Kyushu University Hospital
  • Eri Tomoka
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital
  • Ando Taichi
    Operating Rooms, Kyushu University Hospital
  • Tanabe Miwako
    Operating Rooms, Kyushu University Hospital
  • Osawa Sayaka
    Intensive Care Unit, Kyushu University Hospital
  • Yoshino Jun
    Department of Anesthesiology, Kyushu Hospital
  • Yamaura Ken
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medicine

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説明

Background Noncardiac surgery for adult congenital heart disease patients with Fontan circulation is increasing. Special care must be taken to maintain pulmonary circulation. Pneumonectomy is a particularly challenging procedure for pulmonary circulation because of the intraoperative one-lung ventilation (OLV) and lung resection. In this report, we describe the successful management of a partial pulmonary resection under general anesthesia with remimazolam. Case presentation A 39-year-old woman presented with a right ventricular single ventricle Fontan circulation. A laparoscopic partial pulmonary resection was planned. Remimazolam was used for general anesthesia, stable circulation was obtained with dobutamine and noradrenaline, and postoperative spontaneous respiration was quickly obtained with antagonism by flumazenil and managed with stable respiratory and circulatory dynamics. Conclusion General anesthesia with remimazolam could be one of the options for noncardiac surgery in the Fontan circulation because of its lower circulatory depression and rapid recovery of spontaneous breathing by antagonist.

収録刊行物

  • 循環制御

    循環制御 46 (1), 26-30, 2025

    日本循環制御医学会

詳細情報 詳細情報について

  • CRID
    1390023229738724736
  • DOI
    10.11312/ccm.46.26
  • ISSN
    03891844
  • 本文言語コード
    en
  • データソース種別
    • JaLC
  • 抄録ライセンスフラグ
    使用不可

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