苯磺酸瑞马唑仑联合瑞芬太尼在全身麻醉下子宫全切术中的镇静效果及对脑电双频指数和躁动的影响  

Sedative effect of remimazolam besylate combined with remifentanil in total hysterectomy under general anesthesia and its influence on BIS and restlessness

作　　者：赵嫄 严卫锋 Zhao Yuan;Yan Weifeng(Department of Anesthesiology,Jinhua Maternity and Child Healthcare Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市妇幼保健院麻醉科,浙江金华321000

出　　处：《中国药物与临床》2025年第4期267-272,共6页Chinese Remedies & Clinics

摘　　要：目的探讨需行子宫全切术患者采用苯磺酸瑞马唑仑联合瑞芬太尼进行全身麻醉对其镇静效果、脑电双频指数(BIS)以及躁动的影响。方法选择2021年3月至2023年3月金华市妇幼保健院接收的需行子宫切除术患者88例。根据随机数字表法将所有患者分为2组,对照组和观察组分别44例。对照组采用七氟烷复合瑞芬太尼麻醉,观察组采用瑞马唑仑复合瑞芬太尼麻醉,比较2组不同时间段血流动力学水平[心率、平均动脉压(MAP)]、血清纤溶指标[组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物-1(PAI-1)和D-二聚体(D-D)]、BIS值以及躁动评分(RS)和镇静评分(RSS)。结果观察组手术时间、苏醒时间、离室时间短于对照组(P<0.05);T1、T2、T3时,2组患者心率、MAP、t-PA、PAI-1、D-D水平均高于T0时,但观察组水平低于对照组(P<0.05);T3~T5时,观察组各时间点RS均低于对照组,RSS高于对照组(P<0.05);T1~T3和T6时,2组患者BIS值均下降,且观察组BIS值低于对照组(P<0.05)。结论苯磺酸瑞马唑仑复合瑞芬太尼全身麻醉用于腹腔镜子宫全切术中麻醉效果更佳,且安全性高,值得临床应用。Objective To explore the sedative effect,bispectral index(BIS),and agitation of patients undergoing total hysterectomy under general anesthesia with remimazolam besylate combined with remifentanil.Methods A total of 88 patients who underwent hysterectomy were selected from our hospital between March 2021 and March 2023.According to the digital dynamic randomization method,all patients were divided into a control group and an observation group,with 44 cases in each group.The control group received sevoflurane combined with remifentanil anesthesia,while the observation group received remimazolam besylate combined with remifentanil anesthesia.The hemodynamic levels[heart rate(HR),mean arterial pressure(MAP)],serum fibrinolytic indicators[tissue type plasminogen activator(t-PA),plasminogen activator inhibitor-1(PAI-1),and D-dimer(D-D)],BIS values,as well as agitation(RS)and sedation(RSS)scores,were compared between the two groups at different time periods.Results The observation group had significantly shorter surgical time,recovery time,and departure time compared to the control group(P<0.05);At T1,T2,and T3,the levels of HR,MAP,t-PA,PAI-1,and D-D in both groups of patients were significantly higher than at T0,but the levels in the observation group were significantly lower than those in the control group(P<0.05);At T3~T5,the RS scores of the observation group were lower than those of the control group at all time points,and the RSS scores were higher than those of the control group(P<0.05);At T1~T3 and T6,the BIS values of the both groups of patients significantly decreased,and the BIS values of the observation group were lower than those of the control group(P<0.05).Conclusion The combination of remidazolam besylate and remifentanil for general anesthesia in laparoscopic total hysterectomy is more effective and safe,and is worthy of clinical application.

关 键 词：苯磺酸瑞马唑仑 瑞芬太尼 子宫切除术 镇静效果 脑电双频指数 

分 类 号：R614[医药卫生—麻醉学]