无痛人工流产手术中不同剂量甲苯磺酸瑞马唑仑镇痛镇静效果及对受术者应激反应影响  

Analgesia and sedation effect of different doses of remimazolam tosylate of patients during painless abortion and its influence on the stress response of these patients

作　　者：王调兰 沈翔[1] 江琳[1] 常星[1] 邓燕芳 WANG Diaolan;SHEN Xiang;JIANG Lin;CHANG Xing;DENG Yanfang(The First People's Hospital of Liangshan Yi Autonomous Prefecture,Xichang,Sichuan Province,615000)

机构地区：[1]四川省凉山彝族自治州第一人民医院,西昌615000

出　　处：《中国计划生育学杂志》2023年第2期257-262,共6页Chinese Journal of Family Planning

基　　金：四川省国际医学交流促进会科研课题(L20200509009)。

摘　　要：目的:研究不同剂量甲苯磺酸瑞马唑仑对无痛人工流产手术镇痛镇静效果及对女性应激反应影响。方法:将2020年6月-2020年12月本院收治的拟行无痛人工流产手术女性60例,随机数表法均分为低剂量组(甲苯磺酸瑞马唑仑5mg+舒芬太尼)、中剂量组(甲苯磺酸瑞马唑仑7mg+舒芬太尼)、高剂量组(甲苯磺酸瑞马唑仑8mg+舒芬太尼)各20例,比较各组围术期指标,不同时间点应激反应指标[心率(HR)、平均动脉压(MAP)、呼吸频率(RR)、氧饱和度(SpO_(2))]、镇痛镇静效果[改良警觉/镇静评分(MOAA/S)]、疼痛程度[视觉模拟评分(VAS)],不良反应。结果:3组手术时间、离院时间无差异(P>0.05),低剂量组苏醒时间(8.0±1.2 min)、甲苯磺酸瑞马唑仑总剂量(13.1±1.6 mg)、追加次数(3.2±0.9次)高于中剂量组(7.1±1.3 min、11.2±1.4 mg、1.7±0.5次)、高剂量组(7.1±1.3 min、11.6±1.4 mg、1.5±0.5次)(均P<0.05);HR、MAP、RR、SpO_(2)T1、T2时3组均低于T0(P<0.05);随着给药后时间延长,各组MOAA/S评分逐渐降低,且在各时间点低剂量组、中剂量组、高剂量组比较依次降低(均P<0.05);随着苏醒后时间的延长各组VAS评分均逐渐降低(均P<0.05),但组间无差异;3组不良反应(10.0%、5.0%、5.0%)无差异(P>0.05)。结论:甲苯磺酸瑞马唑仑初始给药剂量7mg联合舒芬太尼用于无痛人工流产手术中麻醉效果确切,镇痛完善,术后苏醒迅速,安全有效。Objective: To explore analgesia and sedation effect of different doses of remimazolam tosylate of patients during painless abortion, and to study its influence on the stress response of these patients. Methods: 60 patients who were scheduled to have painless abortion in the hospital were enrolled and were divided into group A(20 patients with 5 mg of remimazolam tosylate combined with sufentanil for analgesia and sedation), group B(20 patients with 7 mg of remimazolam tosylate combined with sufentanil for analgesia and sedation), and group C(20 patients with 8 mg of remimazolam tosylate combined with sufentanil for analgesia and sedation) according to the random number table method between June 2020 and December 2020. The perioperative indicators, the stress reaction indicators, such as heart rate(HR), mean arterial pressure(MAP), respiratory rate(RR), and oxygen saturation(SpO_(2)), the analgesia and sedation effect, such as modified observer’s assessment of alertness/sedation(MOAA/S), the pain degree by visual analogue scale(VAS), and the occurrence of adverse reactions of the patients at different time points were compared among the three groups. Results: There were no significant differences in the operation time and the hospital stay of the patients among the three groups(P>0.05). The awakening time(8.0±1.2 min), the total dose of remimazolam tosylate(13.1±1.6 mg), and the times of supplemental remimazolam tosylate(3.2±0.9 times) of the patients in group A were significantly higher than those(7.1±1.3 min, 11.2±1.4 mg, and 1.7±0.5 times) of the patients in group B and those(7.1±1.3min,11.6±1.4mg,and 1.5±0.5times)of the patients in group C(P<0.05).The valus of HR,MAP,RR,and SpO_(2)of the patients in the three groups at T1 and T2 were significantly lower than those at T0(P<0.05).The MOAA/S score of the patients in the three groups had decreased gradually with the prolonging of the drugs administration,and which of the patients in group A,group B,and group C at each time point had decreased gradually(

关 键 词：无痛人工流产术 镇痛镇静 甲苯磺酸瑞马唑仑 不同剂量 应激反应 效果 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]