医学
氟马西尼
麻醉
苯二氮卓
叙述性评论
重症监护医学
内科学
受体
作者
Miguel T. Teixeira,Nathan Brinkman,Jeffrey J. Pasternak,Arnoley S. Abcejo
出处
期刊:Journal of Neurosurgical Anesthesiology
[Ovid Technologies (Wolters Kluwer)]
日期:2023-05-31
卷期号:36 (1): 11-19
被引量:12
标识
DOI:10.1097/ana.0000000000000917
摘要
Remimazolam is a novel ultrashort-acting benzodiazepine that produces sedation by acting as a positive allosteric modulator of the gamma-amino butyric acid-A receptor. Its high water solubility and metabolism via tissue esterases allow for a rapid onset of sedation/anesthesia and prompt arousal despite prolonged use. In addition, the effects of remimazolam can be reversed with flumazenil. This narrative review discusses the role of remimazolam in patients undergoing neurosurgical and neuroradiological procedures, specifically its role during awake craniotomies and compatibility with neuromonitoring. Considerations for remimazolam use in patients with neurological diseases are also highlighted. In addition, the impact of remimazolam on postoperative excitation, risk for postoperative delirium, and delayed neurocognitive recovery are discussed. Although there seems to be a clinical promise for remimazolam based on limited case studies and our own institutional experience of its use, further clinical investigation is warranted to understand the potential impact of remimazolam on surgical and neurological outcomes.
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