A case of precipitate in intravenous line when general anesthesia implemented with remimazolam

Adverse reactions caused by drug compatibility are more common in clinical practice, including discoloration, precipitation, crystallization, which can be life-threatening in severe cases. We report a 63-year-old man who developed precipitation during maintenance of general anesthesia with remimazolam tosylate for prostate resection. There were many precipitates in the infusion pipeline and the three-way stopcock, and at that time the infusion liquid was Ringer's acetate solution. Then we investigated the possibility of precipitation with different infusion fluids and remimazolam tosylate. In conclusion, precipitates may not form at a lower remimazolam tosylate concentration and a faster liquid infusion rate and require appropriate attention.