瑞马唑仑联合丙泊酚在鼻部整形手术中的麻醉效果观察  

Observation of Anesthesia Effect of Remimazolam Combined with Propofol in Rhinoplasty Surgery

作　　者：肖兴鹏[1] 李思琦 郑岚[1] 汪华新[1] 马岚[1] Xiao Xingpeng;Li Siqi;Zheng Lan;Wang Huaxin;Ma Lan(Department of Anesthesia,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院麻醉科,武汉430060

出　　处：《药物流行病学杂志》2021年第8期508-511,共4页Chinese Journal of Pharmacoepidemiology

基　　金：湖北省自然科学基金项目(编号:2019CFC853)。

摘　　要：目的:观察瑞马唑仑联合丙泊酚在面部整形手术麻醉中的有效性及安全性。方法:自愿实施鼻部整形手术的女性患者80例随机分为瑞马唑仑组(RM组,瑞马唑仑联合丙泊酚麻醉)和丙泊酚组(PR组,单纯丙泊酚麻醉)各40例。两组患者分别按相应方案完成麻醉。比较两组患者麻醉前(T0)、丙泊酚使用后1 min(T1)、丙泊酚使用后3 min(T2)、苏醒睁眼时(T3)时的收缩压(SBP)、心率(HR)、脉搏氧饱和度(SpO_(2))、Nacortrend指数(NT值)变化,记录两组患者麻醉中丙泊酚用量、静脉麻醉时间、局部麻醉注射时间,以及麻醉中体动和呼吸情况(呼吸频率、呼吸道梗阻、SpO_(2)低于90%和麻醉中辅助呼吸情况)。结果:麻醉后各时点,RM组患者的SpO_(2)及NT值,PR组患者的SBP、HR、SpO_(2)及NT值均较T0时明显降低(P<0.05),但RM组患者T1、T2时点的SBP、HR及SpO_(2)均高于PR患者(P<0.05),变化幅度较小。RM组患者丙泊酚使用量显著少于PR组,麻醉时间及苏醒时间明显短于PR组,呼吸道梗阻及SpO_(2)低于90%的患者比例均低于PR组(P<0.05);两组患者麻醉后呼吸频率均较前显著降低(P<0.05),但RM组患者呼吸频率明显高于PR组(P<0.05)。结论:面部整形麻醉中实施瑞马唑仑联合丙泊酚麻醉,能显著降低对患者呼吸系统的抑制,减少丙泊酚用量,是一种安全有效的麻醉方案。Objective:To observe the effectiveness and safety of remimazolam combined with propofol in anesthesia for facial plastic surgery.Methods:80 female patients who voluntarily performed rhinoplasty were randomly divided into two groups:remimazolam group(RM group,remimazolam combined with propofol anesthesia,n=40)and propofol group(PR group,propofol anesthesia,n=40).The patients in the two groups were anesthetized according to the corresponding anesthesia scheme.The changes of systolic blood pressure(SBP),heart rate(HR),pulse oxygen saturation(SpO_(2))and nacortrend index(NT)were recorded before anesthesia(T0),1 min after propofol use(T1),3 min after propofol use(T2),and when patients waked up and opened their eyes(T3),and other indexes were recorded including the amount of propofol,intravenous anesthesia time,local anesthesia injection time,the case number of body movements and respiration during anesthesia(respiratory rate,the case number of respiratory obstruction,the case number of SpO_(2) less than 90%and the case number of assisted breathing).Results:After anesthesia,the values of SpO_(2) and NT in the RM group,the SBP,HR,SpO_(2) and NT values of the patients in the PR group were significantly lower than those at T0.However,the SBP,HR and SpO_(2) at T1 and T2 in RM group were higher than those in PR group(P<0.05),and the range of changes was small.The dosage of propofol in RM group was significantly less than that in PR group,the anesthesia time and recovery time were significantly shorter than those in PR group,and the proportion of patients with respiratory airway and SpO_(2) lower than 90%in RM group was lower than that in PR group(P<0.05).The respiratory rate of the two groups after anesthesia was significantly lower than that before anesthesia,but the respiratory rate of RM group was significantly higher than that of PR group(P<0.05).Conclusion:Remimazolam combined with propofol anesthesia in nasal plastic anesthesia can significantly reduce the inhibition of the patient’s respiratory system and reduce th

关 键 词：瑞马唑仑 丙泊酚 面部整形 麻醉效果 呼吸 

分 类 号：R971.3[医药卫生—药品]