苯磺酸瑞马唑仑联合舒芬太尼对宫腔镜手术患者血流动力学及应激反应的影响  

Effects of remazolam besylate combined with sufentanil on hemodynamics and stress response in patients undergoing hysteroscopy surgery

作　　者：杨彦军[1] 焦岩[2] 段峰[1] 路一平[1] 郇颖静 杨润楠[3] YANG Yanjun;JIAO Yan;DUAN Feng;LU Yiping;HUAN Yingjing;YANG Runnan(Department of Outpatient,Henan Provincial Corps Hospital of Chinese People’s Armed Police Force,Zhengzhou 450052,China;Department of Anesthesiology,Henan Provincial Corps Hospital of Chinese People’s Armed Police Force,Zhengzhou 450052,China;Department of Medical Engineering,Henan Provincial Corps Hospital of Chinese People’s Armed Police Force,Zhengzhou 450052,China)

机构地区：[1]武警河南总队医院门诊部,郑州450052 [2]武警河南总队医院麻醉科,郑州450052 [3]武警河南总队医院医学工程科,郑州450052

出　　处：《武警医学》2024年第3期222-225,229,共5页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的评价苯磺酸瑞马唑仑麻醉对宫腔镜手术患者血流动力学及应激反应的影响。方法选取择期行宫腔镜手术患者94例,应用随机数字表法分为研究组和对照组各47例。对照组给予丙泊酚联合舒芬太尼,研究组给予苯磺酸瑞马唑仑联合舒芬太尼。比较两组血流动力学、应激反应指标、疼痛和镇静情况,以及不良反应发生情况。结果两组心率(HR)、平均动脉压(MAP)在置入喉罩时(T_(1))、扩张宫颈时(T_(2))、拔除喉罩时(T_(3))与麻醉诱导前(T_(0))比较均明显降低(P<0.05),对照组血氧饱和度(SpO_(2))在T_(1)与T_(0)比较明显降低(P<0.05)。研究组T_(1)、T_(2)、T_(3)时点HR、MAP明显高于对照组(P<0.05)。两组术后2、12、48 h肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)与术前比较均明显升高(P<0.05),且研究组E、NE、Cor明显低于对照组(P<0.05)。研究组术后2、12 h静息VAS评分明显低于对照组(P<0.05),Ramsay评分明显高于对照组(P<0.05)。研究组术后不良反应发生率(6.38%)明显低于对照组(29.79%,P<0.05)。结论与丙泊酚联合舒芬太尼相比,苯磺酸瑞马唑仑联合舒芬太尼在宫腔镜手术中血流动力学更稳定,术后应激反应与疼痛更低,镇静效果良好,不良反应少。Objective To evaluate the effects of remazolam besylate anesthesia on hemodynamics and stress response in patients undergoing hysteroscopic surgery.Methods A total of 94 female patients undergoing hysteroscopic surgery were selected and divided into study group and control group by random number table method(n=47).The control group was given propofol combined with sufentanil,and the study group was given remazolam besylate combined with sufentanil.The hemodynamics,stress response indexes,pain and sedation,and the occurrence of adverse reactions were compared between the two groups.Results Heart rate(HR)and mean arterial pressure(MAP)of the two groups significantly decreased when the laryngeal mask was inserted(T_(1)),cervical dilation(T_(2))and laryngeal mask was removed(T_(3))compared with that before anesthesia induction(T_(0))(P<0.05),and the blood oxygen saturation(SpO_(2))of the control group significantly decreased at T_(1) and T_(0)(P<0.05).HR and MAP of T_(1),T_(2) and T_(3) in the study group were significantly higher than those in the control group(P<0.05).Epinephrine(E),norepinephrine(NE)and cortisol(Cor)in both groups were significantly higher than those before surgery at 2 h,12 h and 48 h after surgery(P<0.05),and E,NE and Cor in the study group were significantly lower than those in the control group(P<0.05).The resting VAS score of the study group was significantly lower than that of the control group at 2 h and 12 h after surgery(P<0.05),and the Ramsay score was significantly higher than that of the control group(P<0.05).The incidence of postoperative adverse reactions in the study group(6.38%)was significantly lower than that in the control group(29.79%,P<0.05).Conclusions Compared with propofol combined with sufentanil,remazolam besylate combined with sufentanil has more stable hemodynamics,lower postoperative stress reaction and pain,good sedation effect and less adverse reactions in hysteroscopic surgery.

关 键 词：苯磺酸瑞马唑仑 丙泊酚 舒芬太尼 宫腔镜手术 血流动力学 应激反应 

分 类 号：R614.2[医药卫生—麻醉学]