Clinical Experience of Using Remimazolam Instead of Volatile Anesthesia for Near-Infrared Photoimmunotherapy.

Remimazolam is a newly-approved anesthetic agent, characterized by minimal hemodynamic fluctuations. We present a case of a patient who received three courses of near-infrared photoimmunotherapy for nasopharyngeal cancer. The patient had heart failure with reduced ejection fraction and aortic valve regurgitation. During the first two courses, the patient was anesthetized by sevoflurane with induction of midazolam and opioids and suffered hypotension requiring continuous infusion of noradrenaline. In the third course, the patient was anesthetized with remimazolam and opioids, and showed hemodynamic stability without the use of noradrenaline. This case report suggests the usefulness of remimazolam for hemodynamically vulnerable patients.