摘要
目的:观察瑞马唑仑用于全凭静脉麻醉诱导及维持的有效性及其安全性。方法:全麻下行择期泌尿外科手术患者80例随机均分为瑞马唑仑组(RM组)和丙泊酚组(PR组),分别使用瑞马唑仑及丙泊酚进行麻醉诱导及维持。记录两组患者麻醉前(T0)、气管插管前(T1)、气管插管后1 min(T2)、手术开始时(T3)、手术开始后30 min(T4)、术后苏醒时(T5)等不同时点的收缩压(SBP)、心率(HR)、BIS值变化;比较两组诱导时间、诱导成功率、手术时间、麻醉时间、苏醒时间;注射部位痛病例数,麻醉诱导维持期间低血压/高血压和心动过缓病例数;以及两组患者拔管后Ramsay镇静评分和术中知晓情况,麻醉期是否做梦、术后不良反应等。结果:麻醉后(T1~T4)两组患者血压和BIS值均较基础值(T0)显著降低(P<0.05);T1、T2时RM组患者血压高于PR组(P<0.05);T1~T4时RM组患者心率变化较小(P>0.05),但PR组患者心率较T0时明显降低(P<0.05),且RM组患者心率明显高于PR组(P<0.05)。两组麻醉诱导时间、诱导成功率、麻醉时间、手术时间及苏醒时间等指标差异无统计学意义(P>0.05)。RM组患者注射部位痛病例数显著少于PR组,且麻醉诱导及维持期间低血压和心动过缓发生率也显著低于PR组(P<0.05)。RM组患者苏醒后5 min、30 min时Ramsay评分均优于PR组(P<0.05)。两组患者均无术中知晓情况发生,RM组患者苏醒后问询麻醉期做梦例数显著多于PR组(P<0.05)。结论:瑞马唑仑用于全凭静脉麻醉诱导及维持时,能获得良好的麻醉效果并能维持较为稳定血压和心率,苏醒质量好,无注射痛且无术中知晓的发生。
Objective: To discuss the efficacy and safety of remimazolam applied to the induction and maintenance of total intravenous anesthesia. Methods: Totally 80 patients undergoing urological surgery were randomly divided into two groups: remimazolam group(RM group) and propofol group(PR group). Remimazolam and propofol were used for the anesthesia induction and maintenance, respectively. The changes of systolic blood pressure(SBP), heart rate(HR) and bispectral index(BIS) were recorded before anesthesia(T0), before endotracheal intubation(T1), and at 1 min after endotracheal intubation(T2), the beginning of operation(T3), 30 min after the beginning of operation(T4), and waking-up after operation(T5). Other indexes were recorded including the induced time, induction success rate, operation time, anesthesia time, awakening time, the cases of injection site pain, and the cases of hypo/hypertension and bradycardia. Meanwhile, the Ramsay sedation score and intraoperative awareness after extubation, dreaming during anesthesia and postoperative adverse reactions were recorded as well. Results: After anesthesia, the blood pressure(T1-T4) and the BIS value of the two groups were significantly lower than the basic value(T0)(P<0.05), but the blood pressure(T1-T2) in RM group was significantly higher than that in PR group(P<0.05). From T1 to T4, the heart rate of patients in RM group had little change(P>0.05), but the heart rate of patients in PR group was significantly lower than that at T0(P<0.05), and the heart rate of patients in RM group was significantly higher than that in PR group(P<0.05). There was no significant difference in anesthesia induction time, induction success rate, anesthesia time, operation time and awakening time between the two groups(P>0.05). The number of patients with injection site pain, the incidence of hypotension and bradycardia during induction and maintenance of anesthesia were all significantly lower than those in PR group(P<0.05), and the Ramsay sedation score in RM group was significantly bette
作者
肖兴鹏
杨璐
田文敏
张小亚
琚冰雁
曹琼华
张蕾
刘恒娟
Xiao Xingpeng;Yang Lu;Tian Wenmin;Zhang Xiaoya;Ju Bingyan;Cao Qionghua;Zhang Lei;Liu Hengjuan(Department of Anesthesiology,Renmin Hospital of Wuhan University,Wuhan 430060,China;Macheng Maternal and Child Health Hospital of Hubei Province;Jiangxia District Hospital of Traditional Chinese Medicine)
出处
《中国药师》
CAS
2022年第11期1976-1979,共4页
China Pharmacist
基金
湖北省自然科学基金面上项目(编号:2020CFB705)。
关键词
瑞马唑仑
静脉麻醉
全身麻醉
丙泊酚
Remmazolam
Intravenous anaesthesia
General anesthesia
Propofol
