• Kota Saito, Sho Ohno, Makishi Maeda, Naoyuki Hirata, and Michiaki Yamakage.
• Department of Anesthesiology, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan. kota.saito23@gmail.com.
• JA Clin Rep. 2021 Mar 6; 7 (1): 21.

BackgroundRemimazolam has less cardiovascular depressant effects than propofol in non-cardiac surgical patients. However, the efficacy and safety of remimazolam in cardiac surgery with cardiopulmonary bypass (CPB) have not been reported. We present a case of successful anesthetic management using remimazolam in cardiac surgery with CPB.Case PresentationA 76-year-old female was scheduled for mitral valve repair, tricuspid annuloplasty, maze procedure, and left atrial appendage closure. We used remimazolam in induction (6.0 mg/kg/h) and maintenance (0.6-1.0 mg/kg/h) of general anesthesia, and the bispectral index value was maintained in the range of 36 to 48 including the period of CPB. Hemodynamics, mixed venous oxygen saturation, and bilateral regional cerebral oxygen saturation were maintained within acceptable ranges. There was no intraoperative awareness/recall or serious complications associated with remimazolam throughout the perioperative period.ConclusionsRemimazolam can be used the same as other existing anesthetics in cardiac surgery with CPB.

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