亚镇静剂量瑞马唑仑对剖宫产术中不良反应及哺乳安全性的影响  

Effects of subhypnotic dose of remimazolam on adverse reactions during cesarean section and postoperative safety of breast feeding

作　　者：庄渊钊 曾景阳[1] 陈英勒[1] 江长城[1] 谢文钦[1] ZHUANG Yuan-zhao;ZENG Jing-yang;CHEN Ying-le;JIANG Chang-cheng;XIE Wen-qin(Department of Anesthesiology,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou FUJIAN 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院麻醉科,福建泉州362000

出　　处：《中国新药与临床杂志》2024年第12期922-925,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的探究术中预防性给予亚镇静剂量瑞马唑仑对剖宫产术中不良反应的影响及术后哺乳安全性的分析。方法选择于腰硬联合麻醉下行剖宫产术的产妇100例,年龄21~43岁,ASAⅠ~Ⅱ级。将产妇随机分为对照组和试验组,每组50例。胎儿娩出后,试验组静脉输注瑞马唑仑,负荷量2.5 mg,并以0.5 mg·kg^(-1)·h^(-1)维持至缝皮前;对照组给予等容量氯化钠注射液。观察胎儿娩出后产妇术中不良反应的发生情况,记录2组初次泌乳时间、新生儿术后24 h和48 h新生儿神经和适应能力评分,检测术后24 h产妇乳汁中瑞马唑仑浓度;记录2组产妇术后疼痛及不良反应发生情况。结果试验组术中寒战、恶心、呕吐发生率显著低于对照组(P<0.05),低血压发生率显著高于对照组(P<0.05)。2组术后泌乳时间、新生儿神经和适应能力评分、疼痛视觉模拟量表(VAS)评分和不良反应发生情况比较,差异无显著意义(P>0.05)。试验组术后24 h母乳中瑞马唑仑浓度为0(0,16.7)μg·L^(-1)。结论胎儿娩出后预防性给予亚镇静剂量瑞马唑仑可有效预防剖宫产术中寒战、恶心、呕吐发生率,且母乳中瑞马唑仑的剂量极低,术后产妇可安全哺乳。AIM To explore the effect of intraoperative prophylactic administration of subhypnotic dose of remimazolam on maternal adverse reactions during cesarean section and analysis of postoperative lactation safety.METHODS Totally 100 lying-in women with cesarean section under combined spinal and epidural anesthesia in our hospital were selected,aged 21-43 years,ASAⅠⅡ.The patients were randomly divided into two groups:remimazolam group(group R)and saline control group(group C),with 50 cases in each group.In the group R,remimazolam was infused intravenously after the delivery of the fetus,with a load of 2.5 mg,0.5 mg·kg^(-1)·h^(-1)maintained until the suture.In the group C,the same amount of normal saline was pumped intravenously after the delivery of the fetus.To record the incidence of adverse reaction of puerpera after fetal delivery.The first lactation time of the two groups of parturients,neurological and adaptive scores of the newborn at 24 hours and 48 hours after the operation were recorded,and the concentration of remimazolam in the milk of the parturients at 24 hours after the operation was detected.Postoperative pain and adverse reactions were recorded in both groups.RESULTS The incidence of shivering,nausea and vomiting during operation in the group R was significantly lower than that in the group C(P<0.05),and the incidence of hypotension was higher than that in the group C(P<0.05).There was no significant difference between the two groups in the time of lactation,neonatal neurological and adaptive ability scores,pain VAS scores and adverse reactions(P>0.05).The concentration of remimazolam in breast milk at 24 h in the group R was 0(0,16.7)μg·L^(-1).CONCLUSION The prophylactic intravenous infusion of remimazolam after fetal delivery can effectively prevent the incidence of shivering,nausea and vomiting of parturients during cesarean section,and the dose of remimazolam taken by newborns through breast milk is extremely low,so the parturients can safely breast feed after cesarean section.

关 键 词：瑞马唑仑 剖宫产术 母乳喂养 不良反应 药物浓度 

分 类 号：R614[医药卫生—麻醉学]