Combination of Remimazolam and Remifentanil for Procedural Sedation and Analgesia in a Patient with Morbid Obesity Undergoing Gastrointestinal Endoscopy under Continuous Positive Airway Pressure: A Case Report

Abstract

Sedation in patients with morbid obesity undergoing gastrointestinal endoscopy (GIE) frequently causes respiratory depression. Remimazolam, a gamma-aminobutyric acid receptor agonist, is safer than propofol as it has fewer cardiovascular and respiratory adverse effects. We report a case of successful GIE under sedation and analgesia with a combination of remimazolam and remifentanil, respectively, in a patient with morbid obesity experiencing obstructive sleep apnea (OSA). Remimazolam ensured safe sedation, preventing complications such as respiratory depression and hypotension. Dose adjustment of remifentanil can minimize its adverse effects. Therefore, the combination of remimazolam and remifentanil is a promising choice for performing GIE in patients with morbid obesity and OSA.

Keywords

• morbid obesity
• remimazolam
• remifentanil
• gastrointestinal endoscopy
• obstructive sleep apnea
• continuous positive airway pressure