• Gwanbeom Kim, Yu Yil Kim, Hyun Joo Heo, and Junyoung Park.
• Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Jeollabuk-Do, Korea.
• Medicine (Baltimore). 2023 Oct 20; 102 (42): e35497e35497.

RationaleRemimazolam, a novel benzodiazepine, is known to have less respiratory depression compared to other anesthetic agents, and it also has a reversal agent that can be used in emergency situations. Remimazolam with these characteristics can be usefully utilized in the anesthetic management of patients with difficult airway.Patient ConcernsA 78-year-old female patient was scheduled proximal humerus fracture surgery. The patient occasionally complained dyspnea and had multiple comorbidities including thyroid goiter, dementia, and delirium.DiagnosesThe patient had a large thyroid goiter compressing and deviating the trachea. A short neck with increased circumference was confirmed. A difficult airway was anticipated in the preanesthetic evaluation.InterventionsSedation with remimazolam followed by regional anesthesia was performed for the surgery.OutcomesThe surgery was completed without complications. The patient recovered and was discharged on 15th postoperative days.LessonsThe use of remimazolam for sedation may be an appropriate option in the anesthetic management of patients with difficult airway.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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