DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.006

Pages: 889-892

Remimazolam is a benzodiazepine sedative favored for its hemodynamic stability, yet clinical data regarding its re-induction shortly after pharmacological reversal with flumazenil remains limited. We present a case of a 60-year-old male (50 kg) who developed septic shock due to an anastomosis rupture following a hemicolectomy. Approximately 120 min after receiving a total of 0.45 mg of flumazenil for anesthesia reversal, the patient required emergency re-operation with hemodynamic instability and a drowsy mental status. Despite the recent flumazenil administration, anesthesia was successfully re-induced with a remimazolam infusion at 6 mg/kg/h. Loss of consciousness was achieved without exacerbating hemodynamic instability. The patient was maintained on remimazolam and continuous vasopressor support, recovered well and was transferred to a general ward on postoperative day 8. This case demonstrates that remimazolam re-induction after flumazenil reversal is a viable and safe strategy, even in hemodynamically compromised patients with septic shock. These findings suggest that remimazolam offers a stable anesthetic alternative for emergency re-operations requiring repeat induction shortly after reversal. Keywords: Remimazolam re-induction, Flumazenil, Remimazolam after flumazenil, Remimazolam in septic shock, Remimazolam in sepsis.