Anestesia e Pesquisa Clínica
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Asleep Flexible Bronchoscopic Intubation with Remimazolam Sedation for Difficult Airway Management: A Case Series

Cynthia W Tan*, Nidhi R Patel, Esther Y Masilamony, Daniel T Rodriguez Correa, Jean D Eloy, Alex Y Bekker

Flexible Bronchoscopic Intubation (FBI) is the accepted standard for managing difficult airways. Sedation is frequently used during awake intubation to make the procedure tolerable. However, this technique has complications, including respiratory depression, hypoxemia, aspiration and airway trauma. Asleep FBI is an alternative approach. Remimazolam, an ultra-short-acting benzodiazepine, is emerging as a suitable drug for FBI of deeply sedated patients with spontaneous breathing. It has several desirable qualities, including rapid onset and offset, easily titratable sedation levels, anxiolysis and hemodynamic stability. We present three successful cases of asleep FBI for patients with difficult airways using Remimazolam as the primary sedative.