不同剂量瑞马唑仑在宫腔镜手术患者全身麻醉维持中的应用效果  

Application effects of different doses of Remimazolam in maintenance of general anesthesia in patients undergoing hysteroscopy surgeries

作　　者：张继珂 王丽[1] 王帅 ZHANG Jike;WANG Li;WANG Shuai(Department of Anesthesiology of Third People’s Hospital of Zhengzhou,Zhengzhou 450000 Henan,China)

机构地区：[1]郑州市第三人民医院麻醉科,河南郑州450000

出　　处：《中国民康医学》2025年第8期75-77,84,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察不同剂量瑞马唑仑在宫腔镜手术患者全身麻醉维持中的应用效果。方法:选取2022年2月至2024年2月于该院行宫腔镜手术的90例患者进行前瞻性研究,按照随机数字表法将其分为R1组(n=30)、R2组(n=30)、R3组(n=30)。三组均进行全身麻醉,R1、R2、R3组分别予以瑞马唑仑0.5、1.0、1.5 mg/(kg·h)进行麻醉维持。比较三组不同时间[麻醉前(T_(0))、麻醉15 min(T_(1))、麻醉30 min(T_(2))、术毕时(T_(3))]血流动力学指标[心率、平均动脉压(MAP)]水平,麻醉相关指标(镇静起效时间、术中瑞马唑仑追加次数、麻醉维持时间、苏醒时间)水平,术后1、3、6 h镇静[警觉-镇静观察评分(OAA/S)]评分,以及不良反应发生率。结果:T_(0)时,三组心率、MAP水平比较,差异均无统计学意义(P>0.05);T_(1)、T_(2)、T_(3)时,三组心率、MAP水平均低于T_(0)时,且R3组低于R1、R2组,差异有统计学意义(P<0.05),但R1组与R2组比较,差异均无统计学意义(P>0.05)。三组镇静起效时间比较,差异无统计学意义(P>0.05);R2、R3组术中瑞马唑仑追加次数均少于R1组,差异有统计学意义(P<0.05);R1、R2组麻醉维持时间、苏醒时间均短于R3组,差异有统计学意义(P<0.05)。术后1、3、6 h,R3组OAA/S评分均低于R1、R2组,差异有统计学意义(P<0.05);但R1组与R2组比较,差异均无统计学意义(P>0.05)。R3组不良反应发生率均高于R1、R2组,差异有统计学意义(P<0.05);但R1组与R2组比较,差异无统计学意义(P>0.05)。结论:1.0 mg/(kg·h)瑞马唑仑应用于宫腔镜手术患者全身麻醉维持可稳定血流动力学指标水平,改善麻醉相关指标水平和术后镇静评分,降低不良反应发生率,效果优于0.5、1.5 mg/(kg·h)瑞马唑仑全身麻醉维持。Objective:To observe application effects of different doses of Remimazolam in maintenance of general anesthesia in patients undergoing hysteroscopy surgeries.Methods:A prospective study was conducted on 90 patients who underwent hysteroscopy surgeries in this hospital from February 2022 to February 2024.According to the random number table method,they were divided into R1 group(n=30),R2 group(n=30)and R3 group(n=30).The three groups were given general anesthesia.R1,R2 and R3 groups were given 0.5,1.0 and 1.5 mg/(kg·h)of Remimazolam for anesthesia maintenance.The levels of hemodynamic indexes[heart rate and mean arterial pressure(MAP)]at different time points[before anesthesia(T_(0)),15 min after anesthesia(T_(1)),30 min after anesthesia(T_(2)),and at the end of surgery(T_(3))],the levels of anesthesia-related indexes(sedation onset time,number of additional Remimazolam during surgery,anesthesia maintenance time,and recovery time),the sedation[observer’s assessment of alertness/sedation(OAA/S)]scores at 1,3,and 6 h after surgery,and the incidence of adverse reactions were compared among the three groups.Results:At T_(0),there were no significant differences in the heart rate and MAP levels among the three groups(P>0.05).At T_(1),T_(2) and T_(3),the heart rate and MAP levels of the three groups were lower than those at T_(0),those in the R3 group were lower than those in the R1 and R2 groups,and the differences were statistically significant(P<0.05);however,there were no significant differences between R1 group and R2 group(P>0.05).There was no statistically significant difference in the sedation onset time among the three groups(P>0.05).The number of additional Remimazolam in group R2 and R3 were less than those in group R1,and the differences were statistically significant(P<0.05).The anesthesia maintenance time and the recovery time in the R1 and R2 groups were shorter than those in the R3 group,and the differences were statistically significant(P<0.05).1,3 and 6 h after the surgery,the OAA/S scores of group

关 键 词：瑞马唑仑 不同剂量 麻醉维持 宫腔镜手术 血流动力学 镇静 不良反应 

分 类 号：R614[医药卫生—麻醉学]