Work

Successful sedation with remimazolam and alfentanil in a child susceptible to malignant hyperthermia: a case report

Year: 2025

Type: article

Abstract: BACKGROUND: Malignant hyperthermia (MH) is a life-threatening autosomal-dominant disorder caused by mutations in the ryanodine receptor 1 (RYR1) gene, leading to calcium dysregulation in skeletal muscle. Patients with genetically confirmed MH susceptibility must strictly avoid volatile anesthetics and succinylcholine. Intravenous sedation presents a viable alternative, yet evidence supporting remimazolam use in pediatric MH patients remains scarce. CASE PRESENTATION: We report the first case of a 1-year-old male patient with genetically confirmed MH susceptibility undergoing orchidopexy under remimazolam-alfentanil sedation combined with caudal block. The patient had no MH manifestations intraoperatively or postoperatively and recovered uneventfully. CONCLUSION: This case demonstrates the feasibility of remimazolam-based sedation in genetically confirmed pediatric MH patients, supporting its safety profile in this population. Further multicenter studies are needed to establish standardized protocols.

Source: BMC Anesthesiology

DOI: 10.1186/s12871-025-03076-0

Authors: Kailai Zhu, Shuangwei Wu, Xianglin Hao, Chuanguang Wang

Institutions: Wenzhou Medical University, Lishui Central Hospital

Language: English

Topic: Anesthesia and Sedative Agents

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,190