Remimazolam Anesthesia for Modified ECT Mitigates Postoperative Agitation: Case Report From Japan

 Out on PubMed, from clinicians in Japan, is this case report.

Remimazolam Anesthesia for Modified Electroconvulsive Therapy Mitigates Postoperative Agitation.

Shimono S, Shakuo T, Yamamura A, Hashimoto M, Masuda R, Shida K.Cureus. 2024 Oct 7;16(10):e71037. doi: 10.7759/cureus.71037. eCollection 2024 Oct.PMID: 39525258



 The abstract is copied below:

Postoperative complications, such as immediate postoperative blood pressure elevation, agitation, and delirium, have been associated with modified electroconvulsive therapy (mECT). Remimazolam may reduce postoperative delirium; however, there are no reports of its use in mECT. Herein, we present a case of effective convulsions and calm arousal with remimazolam in a patient with a history of postoperative agitation. The patient was a 45-year-old man who was diagnosed with severe depression and psychotic symptoms and was treated with electroconvulsive therapy (ECT). Owing to previous episodes of agitation upon awakening, remimazolam and suxamethonium were administered, and mECT was performed under general anesthesia to ensure effective convulsions and calm awakening. Intraoperative vital signs were normal, with no signs of agitation post-treatment. Remimazolam administration for general anesthesia induction for mECT effectively induced convulsions and suppressed postoperative excitation. However, its effect on convulsions during mECT remains unclear, warranting further investigation.

Keywords: anesthesiology; benzodiazepines; depression; modified-electroconvulsive therapy; postoperative agitation; propofol; remimazolam.

The case report is here.
And from the text:





 We have blogged about remimazolam before. This is an interesting case report despite its many, many detail flaws (some of which may be attributed to language issues, see below), so just the general points need be considered.  It is good to have options in ECT anesthesia agents, and management of postictal agitation is important.

The use of "mECT," instead of just "ECT,"often seen in Japanese articles, is annoying and archaic. Reporting the impedance and omitting other important parameters of the ECT course is likewise unfortunate.

And, for general information, regarding remimazolam availability, from OpenEvidence:



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