Remimazolam Use in Anesthetic Management for Transvaginal Oocyte Retrieval: A Case Series.

Transvaginal oocyte retrieval (TVOR) is typically performed under ambulatory intravenous (IV) sedation with preservation of spontaneous ventilation. We retrospectively identified five medically complex patients who received remimazolam as part of individualized anesthetic management for TVOR at a tertiary academic center. Comorbidities included cardiomyopathy, Fontan physiology, pheochromocytoma, difficult airway, and renal transplantation. Spontaneous ventilation was preserved in all cases without airway intervention. Two patients required intermittent phenylephrine, and one required flumazenil for delayed emergence. Median time from operating room exit to discharge readiness was 128 minutes (range 39-149). These cases illustrate clinical scenarios in which remimazolam may support individualized anesthetic strategies for medically complex patients undergoing TVOR.