瑞马唑仑联合阿芬太尼用于无痛人工流产患者的临床研究  

Clinical trial of remazolam combined with alfentanil in the treatment of painless abortion patients

作　　者：陈文海 项敬国 谢应勇 甘怀玉 余建军 CHEN Wen-hai;XIANG Jing-guo;XIE Ying-yong;GAN Huai-yu;YU Jian-jun(Department of Anesthesia,Sanya People’s Hospital,Sanya 572000,Hainan Province,China)

机构地区：[1]三亚市人民医院麻醉科,海南三亚572000

出　　处：《中国临床药理学杂志》2023年第21期3077-3081,共5页The Chinese Journal of Clinical Pharmacology

基　　金：海南省自然科学基金资助项目(822MS177)。

摘　　要：目的观察瑞马唑仑注射剂联合阿芬太尼注射液用于无痛人工流产患者的临床疗效及安全性。方法将拟行无痛人工流产患者随机分为对照组和试验组。对照组给予静脉推注0.3 g·kg^(-1)瑞马唑仑;试验组在对照组治疗的基础上,间隔120 s后静脉推注阿芬太尼,起始剂量500μg,术中追加250μg。比较2组患者的宫缩痛视觉模拟评分(VAS)、肾上腺素、去甲肾上腺素、皮质醇、前列腺素E2、5-羟色胺和神经肽Y、睫毛反射消失时间、苏醒时间、定向力恢复时间等,以及药物不良反应的发生情况。结果试验组入组72例,脱落2例,最终70例纳入分析;对照组入组73例,脱落3例,最终70例纳入分析。试验组术毕和苏醒15、30、60 min时宫缩痛VAS评分分别为(1.70±0.53)、(1.15±0.30)、(1.12±0.32)和(1.10±0.30)分,对照组分别为(2.10±0.89)、(1.81±0.62)、(1.78±0.49)和(1.73±0.42)分,差异均有统计学意义(均P<0.05)。术后,试验组和对照组的肾上腺素分别为(110.41±20.41)和(134.54±18.81)mg·L^(-1),去甲肾上腺素分别为(398.87±34.45)和(432.21±35.51)mg·L^(-1),皮质醇分别为(310.14±46.62)和(340.51±51.18)mg·L^(-1),前列腺素E2分别为(210.41±25.54)和(250.04±24.43)ng·L^(-1),5-羟色胺分别为(322.41±41.15)和(365.30±44.80)ng·mL^(-1),神经肽Y分别为(51.14±11.80)和(63.80±12.19)pg·mL^(-1),差异均有统计学意义(均P<0.05)。试验组和对照组的睫毛反射消失时间分别为(44.90±9.82)和(60.05±11.14)s,苏醒时间分别为(4.70±1.15)和(6.65±1.20)min,定向力恢复时间分别为(5.19±1.30)和(6.80±1.21)min,差异均有统计学意义(均P<0.05)。试验组发生的药物不良反应有头晕、恶心呕吐、呼吸抑制和心动过缓,对照组发生的药物不良反应有头晕、恶心呕吐和躁动。试验组和对照组的总药物不良反应发生率均为11.43%,差异无统计学意义(P>0.05)。结论瑞马唑仑注射剂联合阿芬太尼注射液用于无痛人工流产中�Objective To observe the clinical efficacy and safety of remidazolam injection combined with alfentanil injection for painless abortion patients.Methods Patients who plan to undergo painless abortion were randomly divided into control group and treatment group.The control group was given intravenous injection of 0.3 g·kg^(-1) remidazolam;on the basis of treatment in the control group,the trea tm ent group received intravenous infusion of alfentanil at an interval of 120 seconds,with an initial dose of 500μg,which was added to 250μg during surgery.The visual analogue score(VAS)of uterine contraction pain,adrenaline,Norepinephrine,cortisol,prostaglandin E2,5-hydroxytryptamine and neuropeptide Y,disappearance time of eyelash reflex,recovery time,recovery time of directional force,and the occurrence of adverse drug reaction were compared between the two groups.Results In the treatment group,72 cases were enrolled,2 cases dropped out,70 cases were included in the analysis.In the control group,73 cases were enrolled,3 cases dropped out,70 cases were included in the analysis.The VAS scores of uterine contraction pain in the treatment group were(1.70±0.53),(1.15±0.30),(1.12±0.32)and(1.10±0.30)points at the end of surgery and 15,30,and 60 minutes after awakening,respectively,while in the control group were(2.10±0.89),(1.81±0.62),(1.78±0.49)and(1.73±0.42)points,with statistically significant differences(all P<0.05).After operation,adrenaline levels of the treatment and control groups were(110.41±20.41)and(134.54±18.81)mg·L^(-1);norepinephrine levels were(398.87±34.45)and(432.21±35.51)mg·L^(-1);cortisol levels were(310.14±46.62)and(340.51±51.18)mg·L^(-1);prostaglandin E2 levels were(210.41±25.54)and(250.04±24.43)ng·L^(-1);serotonin levels were(322.41±41.15)and(365.30±44.80)ng·mL^(-1);neuropeptide Y levels were(51.14±11.80)and(63.80±12.19)pg·mL^(-1),respectively.The differences of above indexes were statistically significant(all P<0.05).The disappearance time of eyelash reflex in the treatment an

关 键 词：瑞马唑仑注射剂 阿芬太尼注射剂 无痛人工流产 麻醉效果 安全性评价 

分 类 号：R971.2[医药卫生—药品]