• Shoto Yamada, Kengo Hayamizu, Yukinori Akiyama, Yusuke Kimura, Shuichi Hashimoto, Nobuhiro Mikuni, and Michiaki Yamakage.
• Division of Clinical Engineering, Sapporo Medical University Hospital, South 1, West 16, Chuo-Ku, Sapporo-Shi, Hokkaido, 060-8543, Japan.
• J Anesth. 2023 Apr 1; 37 (2): 311314311-314.

AbstractThere are very few reports on the effects of benzodiazepines such as midazolam and diazepam on intraoperative visual-evoked potential (VEP), and there is no report on the effect of remimazolam at all. Five patients underwent neurosurgery using VEP monitoring for avoiding surgical injury to the optic nerve. In all cases, drug administration was based on actual body weight. General anesthesia was induced with propofol and remifentanil, and then maintained with propofol at target concentrations of 2.7-3.5 µg/ml for maintaining bispectral index (BIS) between 40 and 60. After resection of the tumor under stable VEP, we discontinued propofol immediately followed by infusion of remimazolam at 12 mg/kg/h for a few seconds, then reduced to 1 mg/kg/h. After a time, when blood levels of remimazolam appeared to be stable, VEP was monitored again and compared to controls. In all cases, we were able to confirm that there was reproducibility. Remimazolam may provide a comparable quality of anesthesia to that of existing drugs for VEP in neurosurgery.© 2023. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.

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