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Change in cerebral circulation during the induction of anesthesia with remimazolam

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Abstract

Purpose

Remimazolam is a new ultra-short-acting benzodiazepine with unknown effects on cerebral circulation. We measured total cerebral hemoglobin concentrations, which reflect cerebral blood volume (CBV), and cerebral oxygen saturation, using time-domain near-infrared spectroscopy, which can measure the absolute values of cerebral hemoglobin concentrations. We also measured cerebral blood flow velocity (CBFV) in the middle cerebral artery using transcranial Doppler as an indicator of cerebral blood flow (CBF). We did so to examine the effect of remimazolam on cerebral circulation in humans, as assessed CBV, CBF, and cerebral oxygen saturation.

Methods

This was a prospective, observational study. Fifteen patients without serious complications scheduled for general anesthesia were recruited. We measured total cerebral hemoglobin concentrations, CBFV, and cerebral oxygen saturation throughout the anesthetic induction course with remimazolam.

Results

Total cerebral hemoglobin concentrations did not change during the process (p = 0.51). In contrast, the mean CBFV was reduced by 11% (significant, p = 0.04). The drop in mean blood pressure following the induction of anesthesia was 17%; however, it was within the range of cerebrovascular autoregulation. Moreover, cerebral oxygen saturation increased by 4% (statistically significant, p < 0.01).

Conclusions

We found that anesthetic induction with remimazolam did not alter CBV and reduced CBF in uncomplicated patients.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Anesthesiology, Hokkaido University Hospital, N14, W5, Kita-Ku, Sapporo, 060-8648, Japan

    Takashi Soejima, Kentaro Ueda, Sakae Hasegawa, Hiromitsu Motoe, Koji Hoshino & Yuji Morimoto

  2. Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan

    Kazufumi Okada & Yoichi M. Ito

Authors
  1. Takashi Soejima
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  2. Kentaro Ueda
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  3. Sakae Hasegawa
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  4. Hiromitsu Motoe
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  5. Kazufumi Okada
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  6. Yoichi M. Ito
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  7. Koji Hoshino
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  8. Yuji Morimoto
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Contributions

Takashi Soejima contributed to design of study, data analysis, and preparation of the manuscript. Yuji Morimoto helped with designing of study, acquisition of the original data and drafting the manuscript. Koji Hoshino helped with drafting the manuscript. Kentaro Ueda, Sakae Hasegawa and Hiromitsu Motoe helped with acquisition of the original data. Kazufumi Okada and Yoichi M. Ito helped with statistical analyses. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Takashi Soejima.

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Soejima, T., Ueda, K., Hasegawa, S. et al. Change in cerebral circulation during the induction of anesthesia with remimazolam. J Anesth 37, 92–96 (2023). https://doi.org/10.1007/s00540-022-03135-7

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  • DOI: https://doi.org/10.1007/s00540-022-03135-7

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