Successful remimazolam sedation-epidural block in an older patient with severe chronic obstructive pulmonary disease: A case report

Table 1 Case report timeline

Item		Timeline
Preoperative	1	Discovery of right inguinal mass for > 7 mo
	2	History of hypertension for > 7 years
	3	Pulmonary function was reported to have severe obstructive ventilation dysfunction, mildly reduced total diffusion function, severely increased peripheral airway resistance, abnormal small airway function, and severely increased pulmonary elastic resistance
	4	The operation was performed under remimazolam sedation combined with epidural block anesthesia
Perioperative	5	The patient was admitted to the room at 15:40. The cuff blood pressure, electrocardiograph, saturation of pulse oximetry, and bispectral index was monitored
	6	Invasive blood pressure was monitored and arterial blood gas analysis was conducted. Sedation was provided with 2 mg remimazolam
	7	Induction of anesthesia: epidural puncture and tube placement were performed at 16:00
	8	At 16:25, the level of anesthesia block was determined again, and 5 mg remimazolam was injected to sedate the patient
	9	Surgery was initiated at 16:30
	10	To ensure stable intraoperative sedation, 40 mg/h remimazolam was infused intravenously using a micropump. At 17:05, 5 mL of 2% lidocaine was injected epidurally
	11	At 18:00, the operation was completed
Postoperative	12	The patient gained clear consciousness at 18:02, the patient’s vital signs were stable
	13	The patient’s vital signs were stable for 30 min, and he was returned to the ward at 18:32
	14	The patient was discharged 6 d after surgery
	15	The patient was followed up 2 mo after the operation