瑞马唑仑镇静辅助臂丛神经阻滞在急诊手外伤手术中的应用  

Application of remazolam sedation in assisting brachial plexus block in emergency patients with hand injury

作　　者：潘军里[1] 徐凯[1] 黄云萍[1] PAN Junli;XU Kai;HUANG Yunping(Department of Anesthsiology,Hangzhou Plastic Surgery Hospital,Hangzhou 310011,CHINA)

机构地区：[1]杭州整形医院麻醉科,浙江310011

出　　处：《江苏医药》2022年第11期1163-1165,共3页Jiangsu Medical Journal

摘　　要：目的观察瑞马唑仑用于辅助急诊手外伤患者臂丛神经阻滞(BPB)的临床效果。方法急诊手外伤手术患者120例随机分为两组,每组60例,均在B超引导下完成BPB。BPB辅助用药:A组缓慢静脉注射瑞马唑仑0.1 mg/kg,继以1 mg·kg^(-1)·h^(-1)泵注维持至手术结束;B组缓慢静脉注射丙泊酚2 mg/kg,继以6 mg·kg^(-1)·h^(-1)泵注维持至手术结束。记录两组患者入室时(T0)、手术开始(T1)、手术开始后15 min(T2)和术毕(T3)的MAP、HR、SpO_(2)和警觉/镇静(OAA/S)评分,记录不良反应。结果A组术中T1~T3时的MAP、HR、SpO_(2)和OAA/S评分均高于B组(P<0.05),A组术中体动反应、低血压、呼吸抑制的发生率低于B组(P<0.05或P<0.01)。结论与丙泊酚比较,作为BPB辅助用药,瑞马唑仑镇静可控性好,对生命体征影响小,不良反应少。Objective To observe the clinical effect of remazolam in assisting brachial plexus block(BPB)in emergency patients with hand injury.Methods A total of 120 patients with hand injury underwent emergency surgery under BPB guided by B-ultrasound,who were divided into two groups with 60 cases each.As an adjuvant for BPB,remazolam was used in group A(a loading dose of remazolam was 0.1 mg/kg and 1 mg·kg^(-1)·h^(-1)was pumped until the end of operation)and propofol was used in group B(a loading dose of propofol was 2 mg/kg and 6 mg·kg^(-1)·h^(-1)was pumped until the end of operation).The MAP,HR,SpO_(2)and OAA/S score were recorded at the time points of entering operating room(T0),at the beginning of operation(T1),15 minutes after operation(T2)and at the end of operation(T4).The incidence of adverse reactions was recorded.Results Compared with group B,group A had higher MAP,HR,SpO_(2)and OAA/S score at T1 to T3,and lower incidences of body movement,hypotension and respiratory depression(P<0.05 or P<0.01).Conclusion Compared with propofol,remazolam as an adjuvant for BPB has the advantages of better sedation controll ability,little impact on vital signs and less adverse reactions in the patients undergoing hand injury.

关 键 词：瑞马唑仑 臂丛神经阻滞 手外伤 

分 类 号：R614[医药卫生—麻醉学]