瑞马唑仑联合氟马西尼在儿童快通道心脏外科中的应用  

Effects of remimazolam combined with flumazenil on fast-track cardiac surgery in children

作　　者：黄蓉 曾恒 李晓玲[2] HUANG Rong;ZENG Heng;LI Xiao-ling(Department of Anesthesiology,the First People's Hospital of Guangyuan,Guangyuan SICHUAN 628017,China;Department of Anesthesiology,the First Affiliated Hospital of Gannan Medical University,Ganzhou JIANGXI 341000,China)

机构地区：[1]广元市第一人民医院麻醉科,四川广元628017 [2]赣南医学院第一附属医院麻醉科,江西赣州341000

出　　处：《中国新药与临床杂志》2023年第8期524-527,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的探讨瑞马唑仑联合氟马西尼在儿童快通道心脏外科中的应用价值。方法选择拟行择期心脏手术的患儿60例,ASA分级Ⅱ级,年龄2~10岁,随机分为2组,每组30例。瑞马唑仑组患儿采用瑞马唑仑0.3 mg·kg^(-1)麻醉诱导,1 mg·kg^(-1)·h^(-1)维持;丙泊酚组采用丙泊酚3 mg·kg^(-1)麻醉诱导,8 mg·kg^(-1)·h^(-1)维持。2组其他麻醉方案相同。术毕瑞马唑仑组给予氟马西尼0.01 mg·kg^(-1),丙泊酚组给予等容量氯化钠注射液。记录2组患儿机械通气时间、拔管时间、住院时间和费用,以及血流动力学指标和药物不良反应发生情况。结果与丙泊酚组相比,瑞马唑仑组机械通气时间和拔管时间显著缩短[(64.2±7.4)min vs.(43.4±5.6)min和(75.5±6.2)min vs.(51.0±6.4)min],且住院时间和费用降低[(6.5±0.9)d vs.(5.8±1.0)d和(6.9±1.1)万元vs.(6.3±0.8)万元],差异均有显著意义(P<0.05)。与给药前比较,给药后3 min 2组患儿的平均动脉压和心率均下降,但瑞马唑仑组平均动脉压和心率均显著高于丙泊酚组(P<0.05)。2组不良反应发生率比较,差异无显著意义(P>0.05)。结论瑞马唑仑联合氟马西尼用于儿童快通道心脏外科能够实现早期拔管,减少住院时间和费用,且不增加不良反应的发生。AIM To evaluate the efficacy of remimazolam combined with flumazenil for fast-track cardiac surgery in children.METHODS Sixty pediatric patients undergoing elective cardiac surgery,aged 2 to 10 years,ASA grade,were randomly assigned into two groups(30 cases in each group).The remimazolam group received remimazolam 0.3 mg·kg^(-1)for induction of anesthesia and remimazolam 1 mg·kg^(-1)·h^(-1)for maintenance of anesthesia.The propofol group received propofol 3 mg·kg^(-1)for induction of anesthesia and propofol 8 mg·kg^(-1)·h^(-1)for maintenance of anesthesia.And other anesthesia methods were the same in both groups.At the end of surgery,the remimazolam group received flumazenil 0.01 mg·kg^(-1),the propofol group received the same volume sodium chloride injection.The mechanical ventilation time,extubation time,length and cost of hospital stay,hemodynamic parameters,and adverse drug reactions were recorded.RESULTS The mechanical ventilation time and extubation time were shorter in the remimazolam group than those in the propofol group((43.4±5.6)min vs.(64.2±7.4)min,(51.0±6.4)min vs.(75.5±6.2)min,respectively,P<0.05),and length and cost of hospital stay were decreased((5.8±1.0)d vs.(6.5±0.9)d,(6.3±0.8)ten thousand RMB vs.(6.9±1.1)ten thousand RMB,respectively,P<0.05).Mean arterial pressure and heart rate after drug administration were decreased in both groups,while mean arterial pressure and heart rate 3 min after drug administration were higher in the remimazolam group than those in the propofol group(P<0.05).There were no significant differences in incidence of adverse reactions between the 2 groups(P>0.05).CONCLUSION Remimazolam combined with flumazenil can realize the early extubation,reduce the stay and cost of hospital stay without increasing adverse reactions in pediatric fast-track cardiac surgery.

关 键 词：瑞马唑仑 氟马西尼 丙泊酚 儿童 麻醉 心脏手术 快通道 

分 类 号：R971[医药卫生—药品]