摘要
目的探讨甲苯磺酸瑞马唑仑(简称瑞马唑仑)和丙泊酚对无痛前列腺穿刺患者术后恶心呕吐(PONV)的影响,以期优化前列腺穿刺患者的麻醉方案。方法回顾性分析西安交通大学第一附属医院2023年1月—2024年6月接受无痛前列腺穿刺的1217例患者的临床资料,其中1093例符合纳入标准,按照使用麻醉药物不同分为瑞马唑仑组(n=294),丙泊酚组(n=799)。通过1∶1倾向性评分匹配控制组间混杂因素后,每组267例患者。比较倾向性评分匹配前后两组患者的基线资料,PONV发生率及麻醉苏醒时间。结果倾向性评分匹配前,与丙泊酚组比较,瑞马唑仑组患者的年龄更大[63(49,78)岁vs.66(53,83)岁],身体质量指数(BMI)更大[24.46(20.79,28.91)vs.25.30(21.83,29.23)],术中舒芬太尼使用量更多[7(6,9)μg vs.9(8,10)μg],术中昂丹司琼使用率更高(47.6%vs.55.4%),手术时间更长[15(13,17)min vs.16(14,20)min],差异均有统计学意义(P<0.05)。倾向性评分匹配后,两组患者上述一般资料指标比较,差异均无统计学意义(P>0.05)。倾向性评分匹配前,瑞马唑仑组患者PONV发生率高于丙泊酚组(17.7%vs.11.5%,P=0.007);倾向性评分匹配后,瑞马唑仑组与丙泊酚组患者PONV发生率差异无统计学意义(12.7%vs.17.2%,P=0.146)。倾向性评分匹配前后,瑞马唑仑组患者麻醉苏醒时间均短于丙泊酚组[3(2,4)min vs.7(4,10)min,P<0.001]。结论与丙泊酚相比,瑞马唑仑并不增加无痛前列腺穿刺患者PONV发生率且能缩短麻醉苏醒时间。
Objective To investigate the effects of remimazolam and propofol on postoperative nausea and vomiting(PONV)in patients undergoing painless prostate biopsy,so as to optimize the anesthesia protocols.Methods A retrospective analysis was conducted on the clinical data of 1217 patients who underwent painless prostate biopsy in our hospital during Jan.2023 and Jun.2024.Among them,1093 patients met the inclusion criteria and were divided into two groups:the remimazolam group(n=294)and the propofol group(n=799).After 1∶1 propensity score matching,with 267 patients in either group,a comparison was conducted regarding the incidence of PONV and anesthesia recovery time.Results Before propensity score matching,the remimazolam group had older age[66(53,83)years vs.63(49,78)years],higher body mass index(BMI)[25.30(21.83,29.23)vs.24.46(20.79,28.91)],larger intraoperative use of sufentanil[9(8,10)μg vs.7(6,9)μg],higher intraoperative use rate of ondansetron(55.4%vs.47.6%),and longer surgical duration[16(14,20)min vs.15(13,17)min],with statistically significant differences(P<0.05).There were no statistically significant differences in the aforementioned factors between the two groups after propensity score matching(P>0.05).Before propensity score matching,the incidence of PONV was higher in the remimazolam group than in the propofol group(17.7%vs.11.5%,P=0.007),while after propensity score matching,the incidence of PONV did not differ significantly between the two groups(12.7%vs.17.2%,P=0.146).Before and after propensity score matching,the anesthesia recovery time was significantly shorter in the remimazolam group than in the propofol group[3(2,4)min vs.7(4,10)min,P<0.001].Conclusion Compared with propofol,remimazolam does not increase the incidence of PONV in patients undergoing painless prostate biopsy but can shorten anesthesia recovery time.
作者
杜海亮
梁亮
李岩松
罗大伟
张香
宋平义
朱耀民
DU Hailiang;LIANG Liang;LI Yansong;LUO Dawei;ZHANG Xiang;SONG Pingyi;ZHU Yaomin(Department of Anesthesiology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Urology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)
出处
《现代泌尿外科杂志》
CAS
2024年第9期815-818,共4页
Journal of Modern Urology
