不同剂量苯磺酸瑞马唑仑复合阿芬太尼用于无痛支气管镜检查的麻醉效果比较  

作　　者：边华光 陈沁 张玉光[1] 毛程远 傅爱丽 

机构地区：[1]浙江省浦江县人民医院,322200

出　　处：《浙江临床医学》2025年第3期431-432,438,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨不同诱导剂量的苯磺酸瑞马唑仑在无痛纤支镜检查中的麻醉效果。方法选取2022年10月至2023年10月接受无痛纤维支气管镜检查的患者120例,按随机数字表法分为四组:低剂量瑞马唑仑组(L组,0.2 mg/kg)、中剂量瑞马唑仑组(M组,0.3 mg/kg)、高剂量瑞马唑仑组(H组,0.4 mg/kg)及右美托咪定组(D组,2μg/kg)。收集患者术前一般资料及术中不同时间点的血流动力学数据,采用改良警觉镇静评分(MOAA/S)评估镇静程度,记录诱导时间、停药后苏醒时间及术中、术后不良反应发生率。结果与D组相比,L组,M组和H组诱导时间缩短(P<0.05),与L组相比,H组、M组的诱导时间较短(P<0.05);与其他三组相比,H组患者术后苏醒时间延长(P<0.05)。术中及术后不良反应比较,与D组相比,L组、M组及H组术后咳嗽发生率较低(P<0.05);与L组相比,M组、H组患者术中体动反应发生情况较少(P<0.05)。结论相比右美托咪定诱导,苯磺酸瑞马唑仑的诱导时间更短,术后咳嗽发生率较低,中等剂量的苯磺酸瑞马唑仑(0.3 mg/kg)苏醒时间更短,麻醉效果更好,更适用于无痛纤支镜检查的诱导。Objective To investigate the anesthetic efficacy of different induction doses of remimazolam besylate in painless fiberoptic bronchoscopy.Methods A total of 120 patients undergoing painless fiberoptic bronchoscopy at our hospital from October 2022 to October 2023 were selected and randomly divided into four groups using a random number table:the low-dose remimazolam group(L group,0.2 mg/kg),the medium-dose remimazolam group(M group,0.3 mg/kg),the high-dose remimazolam group(H group,0.4 mg/kg),and the dexmedetomidine group(D group,2μg/kg).Preoperative general data and intraoperative hemodynamic parameters at different time points were collected.The modified Observer's Assessment of Alertness/Sedation(MOAA/S)scale was used to assess sedation depth.Induction time,recovery time after drug discontinuation,and the incidence of intraoperative and postoperative adverse reactions were recorded.Results Compared with group D,the induction time in groups L,M,and H was significantly shorter(P<0.05).Compared with group L,the induction time in groups H and M was shorter(P<0.05).The recovery time in group H was significantly longer than in the other three groups(P<0.05).The incidence of postoperative cough was lower in groups L,M,and H compared with group D(P<0.05).Patients in groups M and H exhibited fewer intraoperative body movements compared with group L(P<0.05).Conclusion Compared with dexmedetomidine,remimazolam besylate provides a s horter induction time and lower incidence of postoperative cough.Among the doses tested,medium-dose remimazolam(0.3 mg/kg)offers a shorter recovery time and better anesthetic efficacy,making it more suitable for induction in painless fiberoptic bronchoscopy.

关 键 词：苯磺酸瑞马唑仑 右美托咪定 纤支镜 无痛诊疗 

分 类 号：R614[医药卫生—麻醉学]