瑞马唑仑用于腹部手术患者全麻诱导与维持的效果  

Efficacy of remimazolam for induction and maintenance of general anesthesia in patients undergoing abdominal surgery

作　　者：赵晓咏 夏瑞[1] 刘香玉 刘伟伟[1] 唐丽 徐伟[1] 李启飞[1] Zhao Xiaoyong;Xia Rui;Liu Xiangyu;Liu Weiwei;Tang Li;Xu Wei;Li Qifei(Department of Anesthesiology,the First Affiliated Hospital of Yangtze University,Jingzhou 434000,China)

机构地区：[1]长江大学附属第一医院麻醉科,荆州434000

出　　处：《中华麻醉学杂志》2021年第7期823-826,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价瑞马唑仑用于腹部手术患者全麻诱导与维持的效果。方法择期行气管插管全身麻醉的腹部手术患者100例,性别不限,年龄18~64岁,BMI 18~30 kg/m^(2),ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为2组(n=50):瑞马唑仑组(R组)和丙泊酚组(P组)。麻醉诱导:P组静脉注射丙泊酚1.0~2.5 mg/kg,R组静脉输注瑞马唑仑0.15~0.35 mg/kg,2组均静脉注射舒芬太尼0.4~0.5μg/kg和罗库溴铵0.6 mg/kg。麻醉维持:R组静脉输注瑞马唑仑0.3~1.0 mg·kg^(-1)·h^(-1),P组静脉输注丙泊酚4~12 mg·kg^(-1)·h^(-1),2组均静脉输注瑞芬太尼8~15μg·kg-1·h-1。术中维持Narcrotrend指数(NI)值37~64(即D0~D2)。记录镇静成功情况、患者意识消失时间、睫毛反射消失时间、NI值降至D0时间,意识消失后HR降低程度、VT、RR、呼吸暂停发生情况、苏醒时间、PACU滞留时间,记录诱导1、3、5 min时MAP波动程度以及术中、术后不良事件的发生情况。结果2组镇静成功率均为100%。与P组比较,R组意识消失时间、睫毛反射消失时间、NI值降至D0时间延长,意识消失后VT、RR升高,呼吸暂停发生率降低,苏醒时间缩短,术中窦性心动过缓、注射痛、术中梦境发生率降低,诱导1、3、5 min时MAP波动程度减小(P<0.05)。结论瑞马唑仑可安全有效地用于腹部手术患者全麻诱导与维持,其诱导剂量为0.15~0.35 mg/kg,维持剂量为0.3~1.0 mg·kg^(-1)·h^(-1)。Objective To evaluate the efficacy of remimazolam for induction and maintenance of general anesthesia in patients undergoing abdominal surgery.Methods A total of 100 patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m^(2),of American Society of Anesthesiologists physical statusⅠorⅡ,undergoing elective abdominal surgery with general anesthesia requiring tracheal intubation,were enrolled in this study and divided into 2 groups(n=50 each)using a random number table method:remimazolam group(group R)and propofol group(group P).Anesthesia was induced by intravenously infusing propofol 1.0-2.5 mg/kg in group P and remimazolam 0.15-0.35 mg/kg in group R.Sufentanil 0.4-0.5μg/kg and rocuronium 0.6 mg/kg were intravenously injected in group R and group P.Anesthesia was maintained by intravenously injecting remimazolam 0.3-1.0 mg·kg^(-1)·h^(-1) in group R and propofol 4-12 mg·kg^(-1)·h^(-1) in group P.Remifentanil 8-15μg·kg-1·h-1 was intravenously injected in group R and group P.Narcrotrend index(NI)was maintained at 37-64(D0-D2).The success of sedation,time for loss of consciousness,time of disappearance of eyelash reflex,time when NI dropped to D0,incidence of tidal volume,respiratory rate and apnea after the patients lost consciousness,duration of stay in post-anesthesia care unit,the fluctuation range of mean arterial pressure at 1,3 and 5 min of induction,and the development of intraoperative and postoperative adverse events.Results The success rate of sedation in group R and group P was 100%.Compared with group P,time for loss of consciousness,time of disappearance of eyelash reflex and time when NI dropped to D0 were significantly prolonged,tidal volume and respiratory rate were increased,the incidence of apnea after the patients lost consciousness was decreased,awakening time was shortened,the incidence of intraoperative sinus bradycardia,injection pain and dream was decreased,fluctuation range of blood pressure at 1,3 and 5 min of induction was decreased in group R(P<0.05).Conclusion

关 键 词：苯二氮䓬类 麻醉 全身 

分 类 号：R614[医药卫生—麻醉学]