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Remimazolam and a nasopharyngeal airway in a difficult gastroscopy case: a combined intervention
A case involving obesity and obstructive sleep apnea describes successful gastroscopy after changing both the sedative approach and airway support.
A case involving obesity and obstructive sleep apnea describes successful gastroscopy after changing both the sedative approach and airway support.
The clinical sequence
The report concerned a patient with obesity, obstructive sleep apnea, and an anticipated difficult airway. A prior propofol-based attempt was stopped after coughing and hypoxemia. During the subsequent attempt, clinicians used remimazolam and placed a nasopharyngeal airway before the procedure.
The reported course included maintained spontaneous ventilation and stable procedural conditions, followed by flumazenil reversal. The sequence is informative because it records the airway strategy as well as the change in drug.
Why the successful second attempt has limits
Both the sedative and airway management changed. A single case therefore cannot determine how much each change contributed, compare complication rates, or establish that this combination is safe for every patient with sleep apnea. Differences between the two attempts may also extend beyond the named interventions.
For review of a sedation event, reconstruct oxygen delivery, airway positioning, support devices, medication timing, ventilation observations, and recovery. The paper supports examining the entire sedation process. It does not support attributing a good or bad oxygenation outcome solely to the benzodiazepine, nor does use of a reversible sedative remove the need to document respiratory monitoring.
Source paper
Original analysis of the supplied journal article, identified as PMC12932518.