甲苯磺酸瑞马唑仑对心脏瓣膜手术患者术后早期恢复质量的影响  

Effect of remimazolam tosilate on early postoperative recovery quality in patients undergoing cardiac valve surgery

作　　者：张娜娜 周俊辉[1] 任苏恩[1] 钟巍[1] ZHANG Na-na;ZHOU Jun-hui;REN Su-en;ZHONG Wei(Department of Anesthesiology,Henan Chest Hospital,Zhengzhou 450001,Henan,CHINA)

机构地区：[1]河南省胸科医院麻醉科,河南郑州450001

出　　处：《海南医学》2025年第5期635-638,共4页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20200220)。

摘　　要：目的探讨甲苯磺酸瑞马唑仑对心脏瓣膜手术患者术后早期恢复质量的影响。方法前瞻性选取2021年3月至2024年5月拟在河南省胸科医院接受心脏瓣膜手术的120例患者进行研究,按随机数表法分为丙泊酚组和甲苯磺酸瑞马唑仑组各60例。比较两组患者麻醉诱导前、意识消失时、气管插管后1 min及手术开始后1 min的平均动脉压(MAP)及心率(HR),并比较两组患者恢复情况[术毕至苏醒、拔管时间、术后恢复质量评分量表(QoR-15)评分]和术中及术后不良反应发生率。结果两组患者意识消失时、气管插管后1 min、手术开始后1 min的MAP及HR均低于麻醉诱导前,且甲苯磺酸瑞马唑仑组患者的上述指标明显高(快)于同时间点的丙泊酚组,差异均有统计学意义(P<0.05);甲苯磺酸瑞马唑仑组患者术毕至苏醒时间、气管导管拔除时间分别为(51.33±6.74)min、(5.02±0.61)h,明显早于丙泊酚组的(64.14±8.20)min、(7.20±0.89)h,QoR-15评分为(109.98±10.02)分,明显高于丙泊酚组的(100.11±8.96)分,差异均有统计学意义(P<0.05);甲苯磺酸瑞马唑仑组患者术中不良反应总发生率为5.00%,明显低于丙泊酚组的18.33%,差异有统计学意义(P<0.05),而甲苯磺酸瑞马唑仑组患者术后不良反应总发生率为11.67%,略低于丙泊酚组的20.00%,差异无统计学意义(P>0.05)。结论甲苯磺酸瑞马唑仑能够提高心脏瓣膜手术患者术后早期恢复质量,减少术中血流动力学波动,缩短术后苏醒时间及气管导管的拔除时间。Objective To investigate the effect of remimazolam tosilate on early postoperative recovery quality in patients undergoing cardiac valve surgery.Methods This prospective study enrolled 120 patients scheduled for cardiac valve surgery at Henan Chest Hospital from March 2021 to May 2024.Participants were randomly divided into two groups(n=60 each)according to random number table method:the propofol group and the remimazolam tosilate group.Mean arterial pressure(MAP)and heart rate(HR)were compared at four time points:before anesthesia induction,loss of consciousness,1 minute after tracheal intubation,and 1 minute after surgery initiation.Recovery parameters(time to awakening,extubation time,Quality of Recovery-15[QoR-15]score)and incidences of intraoperative/postoperative adverse reactions were also analyzed.Results MAP and HR decreased at loss of consciousness,1 minute after tracheal intubation,and 1 minute after surgery initiation compared to pre-induction values in both groups.However,the remimazolam tosilate group exhibited significantly higher MAP and faster HR at these time points than the propofol group(P<0.05).The remimazolam tosilate group demonstrated shorter awakening time and extubation time,along with higher QoR-15 scores,compared to the propofol group(all P<0.05):awakening time,(51.33±6.74)min vs(64.14±8.20)min;extubation time,(5.02±0.61)h vs(7.20±0.89)h;QoR-15 scores,(109.98±10.02)points vs(100.11±8.96)points.The total rate of intraoperative adverse reactions was significantly lower in the remimazolam tosilate group(5.00%vs 18.33%,P<0.05),while the postoperative adverse reaction rate showed no significant difference(11.67%vs 20.00%,P>0.05).Conclusion Remimazolam tosilate improves early postoperative recovery quality in patients undergoing cardiac valve surgery by stabilizing hemodynamics,shortening awakening and extubation times,and reducing intraoperative adverse events.

关 键 词：心脏瓣膜手术 甲苯磺酸瑞马唑仑 丙泊酚 全身麻醉 

分 类 号：R654[医药卫生—外科学]