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Updated: Jul 13, 2026

Intra-Operative Neural Monitoring of Thyroid Surgery in a Porcine Model
Published on: February 11, 2019
Remimazolam sedation with regional anesthesia in difficult airway due to huge thyroid goiter: A case report
Gwanbeom Kim1, Yu Yil Kim, Hyun Joo Heo
1Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Jeollabuk-Do, Korea.
Rationale:
Remimazolam, 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 Concerns:
A 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.
Diagnoses:
The 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.
Interventions:
Sedation with remimazolam followed by regional anesthesia was performed for the surgery.
Outcomes:
The surgery was completed without complications. The patient recovered and was discharged on 15th postoperative days.
Lessons:
The use of remimazolam for sedation may be an appropriate option in the anesthetic management of patients with difficult airway.
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