不同剂量瑞马唑仑在超声引导骶管阻滞痔切除术中的应用研究  

Clinical application study of different doses of remimazolam in ultrasound-guided caudal block for hemorrhoidectomy

作　　者：刘涛 张辉[1] 谢晨 LIU Tao;ZHANG Hui;XIE Chen(Department of Anesthesiology,the First People’s Hospital of Huzhou,Huzhou 313000,Zhejiang,China)

机构地区：[1]湖州市第一人民医院麻醉科,浙江湖州313000

出　　处：《中国现代医生》2025年第3期49-52,共4页China Modern Doctor

基　　金：浙江省湖州市科学技术局公益性应用研究项目(2022GYB17)。

摘　　要：目的探讨不同剂量瑞马唑仑在超声引导下骶管阻滞痔切除术中的镇静效果及对血流动力学的影响。方法选取2023年6月至2024年5月在湖州市第一人民医院接受超声引导骶管阻滞痔切除术的90例患者,随机分为A、B、C三组,每组30例。分别给予瑞马唑仑0.2mg/(kg·h)、0.3mg/(kg·h)、0.5mg/(kg·h)静脉泵注进行镇静。比较三组的镇静效果,记录镇静前(T_(0))、给药后即刻(T_(1))、扩肛时(T_(2))、痔切除时(T_(3))、手术结束时(T_(4))及苏醒时(T_(5))的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、脉搏血氧饱和度(pulse oxygen saturation,SpO_(2))和呼吸频率(respiratory rate,RR)的变化,并记录三组患者的不良反应发生情况。结果与C组比较,A组和B组患者的镇静苏醒时间短、镇静成功率低,差异有统计学意义(P<0.05)。与T_(0)比较:三组患者T_(1)~T_(4)时的MAP、SpO_(2)、RR均降低,T_(3)~T_(5)时HR降低(P<0.05)。三组间相同时间点MAP、HR比较差异无统计学意义(P>0.05),三组间相同时间点的SpO_(2)、RR比较差异有统计学意义(P<0.05)。C组不良反应发生率高于A组、B组,差异有统计学意义(P<0.05)。A组与B组比较差异无统计学意义(P>0.05)。结论瑞马唑仑在超声引导骶管阻滞痔切除术中的镇静效果满意,对血流动力学影响小、安全性好,以0.3mg/(kg·h)剂量最佳。Objective To explore the sedative effects of different doses of remimazolam in ultrasound-guided caudal block for hemorrhoidectomy and its impact on hemodynamics.Methods A total of 90 patients undergoing ultrasound-guided caudal block for hemorrhoidectomy from June 2023 to May 2024 in the First People’s Hospital of Huzhou were selected and randomly divided into three groups:group A,group B,group C,with 30 cases in each group.Remimazolam was administered via intravenous pump at doses of 0.2mg/(kg·h),0.3mg/(kg·h),and 0.5mg/(kg·h)for sedation.The sedative effects among three groups were compared,and changes in mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO_(2)),and respiratory rate(RR)were recorded at baseline(T_(0)),immediately after administration(T_(1)),during anal dilation(T_(2)),during hemorrhoidectomy(T_(3)),at the end of surgery(T_(4)),and at awakening(T_(5)).The occurrence of adverse reactions among three groups was also recorded.Results Compared to group C,group A and group B had shorter sedation awakening times and lower sedation success rates,with statistically significant differences(P<0.05).Compared to T_(0),MAP,RR,and SpO_(2) decreased in all three groups at T_(1)-T_(4),and HR decreased at T_(3)-T_(5)(P<0.05).There were no significant differences in MAP and HR among three groups(P>0.05),but significant differences were observed in SpO_(2) and RR at the same time points(P<0.05).The incidence of adverse reactions in group C was higher than in group A and group B,with statistically significant differences(P<0.05).There was no statistically significant difference between group A and group B(P>0.05).Conclusion Remimazolam provides satisfactory sedation in ultrasound-guided caudal block for hemorrhoidectomy,has minimal impact on hemodynamics,and is safe,with a recommended optimal dose of 0.3mg/(kg·h).

关 键 词：瑞马唑仑 超声引导 骶管阻滞 痔切除术 镇静效果 

分 类 号：R614.4[医药卫生—麻醉学]