低剂量持续输注瑞马唑仑对颌面外科术后患者首夜睡眠质量的影响  

Effect of low-dose continuous infusion of remimazolam on sleep quality on the first night after maxillofacial surgery

作　　者：王烨 邓晓明 王磊 刘全乐 靳紫彬 王静雯 魏灵欣 杨冬 Wang Ye;Deng Xiaoming;Wang Lei;Liu Quanle;Jin Zibin;Wang Jingwen;Wei Lingxin;Yang Dong(Department of Anesthesiology,Plastic Surgery Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院麻醉科,100144

出　　处：《北京医学》2024年第2期127-130,134,共5页Beijing Medical Journal

摘　　要：目的 探讨低剂量持续输注瑞马唑仑对颌面外科术后患者首夜睡眠质量的影响。方法 选取2021年8月9日至2013年8月9日中国医学科学院整形外科医院颌面外科手术患者80例。随机分为对照组和瑞马唑仑组,每组40例。对照组术后无镇静药物输注,瑞马唑仑组术后首夜低剂量持续输注瑞马唑仑[0.2 mg/(kg·h)]。比较两组术后首夜N1、N2、N3及快动眼(rapid eye movement, REM)期睡眠时间、清醒时间、觉醒次数、睡眠效率,术后首夜不良反应及镇静镇痛药物补救情况。结果 80例患者中,男16例,女64例,年龄18~40岁,平均(26.3±5.7)岁。瑞马唑仑组N1期睡眠时间及睡眠效率高于对照组[177.7(108.1,262.4)min比90.5(70.6,131.8)min、81.3%(54.7%,96.0%)比68.6%(53.4%,82.8%)]、REM期睡眠时间及觉醒次数低于对照组[2.3(0.0,11.1)min比47.1(1.6,91.1)min、6.5(2.0,12.0)次比26.0(18.3,43.3)次];瑞马唑仑组SpO2<90%及心动过速的比例高于对照组(70.0%比37.5%、95.0%比80.0%),差异均有统计学意义(P<0.05),两组其他不良反应及镇静镇痛药物补救情况的比较,差异均无统计学意义(P>0.05)。结论 低剂量持续输注瑞马唑仑可有效延长颌面外科患者术后N1期睡眠时间,缩短REM期睡眠时间,减少觉醒次数,提高睡眠效率,无严重不良反应。Objective To explore the effect of low-dose continuous infusion of remimazolam on the quality of sleep on the first night after maxillofacial surgery.Methods A total of 80 patients with maxillofacial surgery in Plastic Surgery Hospital,Chinese Academy of Medical Sciences from August 9,2021 to August 9,2013 were selected,and were randomly divided into control group and remimazolam group,with 40 cases in each group.There was no sedative drug infusion in the control group after operation,and low-dose continuous infusion of remimazolam[0.2 mg/(kg·h)]was given in the remimazolam group on the first night after operation.The sleep time of N1,N2,N3 and rapid eye movement(REM)on the first night after operation,waking time,awakening times,sleep efficiency,adverse reactions on the first night after operation,and sedation and analgesia remedies were compared between the two groups.Results Among the 80 patients,there were 16 males and 64 females,aged from 18 to 40 years,with an average of(26.3±5.7)years.The sleep time of N1 and sleep efficiency of the remimazolam group were higher than those of the control group[177.7(108.1,262.4)min vs.90.5(70.6,131.8)min,81.3%(54.7%,96.0%)vs.68.6%(53.4%,82.8%)];the sleep time of REM and awakening times were lower than those in control group[2.3(0.0,11.1)min vs.47.1(1.6,91.1)min,6.5(2.0,12.0)times vs.26.0(18.3,43.3)times];the ratio of SpO2<90%and tachycardia in remimazolam group were higher than those in control group(70.0%vs.37.5%,95.0%vs.80.0%),and the differences were statistically significant(P<0.05).There was no significant difference between the two groups in other adverse reactions and sedative and analgesic drugs(P>0.05).Conclusions Low-dose continuous infusion of remimazolam can effectively prolong the sleep time of N1,shorten the sleep time of REM,reduce the awakenings times,improve sleep efficiency and have no serious adverse reactions.

关 键 词：瑞马唑仑 低剂量持续输注 睡眠质量 颌面外科手术 术后首夜 多导睡眠监测 

分 类 号：R782.054[医药卫生—口腔医学]