General Anesthesia With Remimazolam in Fontan Procedure: A Case Report

The Fontan procedure requires anesthetics, allowing rapid awakening for early extubation and less circulatory depression owing to passive pulmonary blood flow hemodynamics. Remimazolam, a short-acting benzodiazepine, may be a suitable anesthetic choice; however, its use in this procedure is unreported. We present a 2-year-old boy with a single-right ventricle and pulmonary valve stenosis who underwent the Fontan procedure under anesthesia with remimazolam (3-8 mg kg-1 h-1) and fentanyl (21.8 μg/kg). Hemodynamics remained stable under electroencephalographic monitoring, and the patient was extubated in the operating room without any complications. Therefore, remimazolam may be a feasible sedative option during the Fontan procedure.