• Yasuhiro Morimoto, Aya Yoshimatsu, and Manabu Yoshimura.
• Department of Anesthesia, Ube Industries Central Hospital, 750 Nishikiwa Ube, Yamaguchi, 755-0151, Japan. yasumorimo@gmail.com.
• JA Clin Rep. 2021 Jan 12; 7 (1): 10.

BackgroundPatients with myotonic dystrophy may have increased sensitivity to drugs used for anesthesia. We successfully managed general anesthesia in a patient with myotonic dystrophy using a novel intravenous anesthetic, remimazolam.Case PresentationThe patient was a 46-year-old man, 169 cm in height, and weighing 60 kg. He was diagnosed with myotonic dystrophy 5 years previously. Phacoemulsification for both eyes was scheduled under general anesthesia. Anesthesia was induced with remimazolam 6 mg/kg/h for 1 min and maintained by continuous infusion at 0.25 mg/kg/h during surgery, a 1/4 dose of the standard infusion rate, as indexed by a bispectral index (BIS). Six minutes after remimazolam discontinuation, the patient opened his eyes on verbal command with sufficient spontaneous respiration. Flumazenil (0.2 mg) was administered to boost the patient's recovery.ConclusionIn addition to the short-acting anesthetic remimazolam, the presence of the antagonist flumazenil enabled complete recovery from anesthesia, without postoperative complications.

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