脑电双频谱指数指导下瑞马唑仑联合舒芬太尼对女性患者全麻诱导气管插管应激反应的影响  

Impact of the combination of remimazolam and sufentanil under bispectral index guidance on the stress response to tracheal intubation during general anesthesia in female patients

作　　者：刘国澜 彭丹萍 于俊相 潘侠[3] LIU Guolan;PENG Danping;YU Junxiang;PAN Xia(Dept.of Anesthesiology,Traditional Chinese Medicine Hospital ofHonghu City,Honghu 433200,Hubei,China;Dept.of Anesthesiology,Jinghai Hospital of Tianjin City,Jinghai 301669,Tianjin,China;Dept.of Anesthesiology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]洪湖市中医医院麻醉科,湖北洪湖433200 [2]天津市静海区医院麻醉科,天津静海301669 [3]武汉大学人民医院麻醉科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2024年第8期958-962,984,共6页Medical Journal of Wuhan University

基　　金：湖北省卫生健康委员会科研指导项目(编号:WJ2021F087)。

摘　　要：目的:在目标脑电双频谱指数(BIS)指导下,观察瑞马唑仑联合舒芬太尼对女性患者全麻气管插管应激反应的影响。方法:纳入气管插管全麻下择期手术女性患者78例(年龄18~65岁,ASAⅠ~Ⅱ级,18 kg/m^(2)≤BMI≤30 kg/m^(2)),将其随机分为瑞马唑仑组和丙泊酚组,每组39例。患者入室后常规监测心率(HR)、血压(BP)和脉搏氧饱和度(SpO2),BIS监测患者镇静深度。使用瑞马唑仑和丙泊酚分别诱导两组患者,当两组患者在BIS值40~60时进行气管插管,记录两组患者麻醉诱导开始时(T0),气管插管时(T1),气管插管后1 min(T2),气管插管后5 min(T3)时的血流动力学、血糖变化及诱导时间、低血压、呼吸抑制等不良事件发生率。结果:瑞马唑仑组与丙泊酚组镇静成功率都是100%,但瑞马唑仑组的诱导时间较丙泊酚更长(P<0.05);诱导期间,瑞马唑仑组患者的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)及血糖在T1、T2时间点较丙泊酚组患者差异有统计学意义(P<0.05),低血压、呼吸抑制等不良事件发生率明显低于丙泊酚组(P<0.05)。结论:瑞马唑仑用于女性患者全麻诱导,血流动力学更加平稳,不良反应更少,安全性较高。Objective To observe the effect of remimazolam combined with sufentanil on the stress response of tracheal intubation under general anesthesia in female patients under the guidance of target bispectral index(BIS).Methods A total of 78 female patients under general anesthesia with endotracheal intubation(age 18⁃65 years,ASA classⅠ⁃Ⅱ,18 kg/m^(2)≤BMI≤30 kg/m^(2))were randomly divided into the remimazolam group and propofol group,with 39 cases in each group.After the patients entered the operation room,their heart rate(HR),blood pressure(BP),and pulse oxygen saturation(SpO2)were routinely monitored.The depth of sedation was monitored by BIS.Remimazolam and propofol were used respectively to induce anesthesia of the patients in the two groups.Endotracheal intubation was performed in both groups at a BIS value of 40‑60.T0 at the beginning of anesthesia induction,T1 at endotracheal intubation,and T2 at 1 minute after endotracheal intubation were recorded.Hemodynamics,blood glucose changes,induction time,hypotension,respiratory depression,and other adverse events were recorded at the time points of tracheal intubation(T0:at the beginning of anesthesia induction,T1:at endotracheal intubation and T2:at 1 minute after endotracheal intubation).Results The sedation success rates of the remimazolam group and the propofol group were both 100%,but the induction time of the remimazolam group was longer than that of propofol(P<0.05);during the induction period,the remimazolam group had a longer induction time than the propofol group.The systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),and blood glucose of patients in the remimazolam group were significantly different from those in the propofol group at T1 and T2 time points(P<0.05).Hypotension,respiratory depression,and other adverse events were significantly lower than those in the propofol group(P<0.05).Conclusion Remimazolam is used to induce general anesthesia in female patients,with more stable hemodynamics,fewer adverse rea

关 键 词：脑电双频谱指数 瑞马唑仑 丙泊酚 麻醉诱导期 应激反应 气管导管 

分 类 号：R713[医药卫生—妇产科学]