瑞马唑仑与丙泊酚在全身麻醉手术中的安全性与有效性

Efficacy and safety of remazolam and propofol in general anesthesia during surgery

目的:系统性评价瑞马唑仑与丙泊酚在全麻手术中的安全性与有效性。方法:系统性检索中国知网、中国生物医学文献数据库、万方数据库、维普数据库、Web of Science、PubMed、Embase、Cochrane Library,检索时间为建库至2022年4月,收集有关全身麻醉手术中应用瑞马唑仑与丙泊酚的文献资料。对纳入文献进行质量评价及数据提取,采用RevMan 5.3软件进行Meta分析。结果:筛选出文献17篇,纳入患者1983例。Meta分析结果显示,与丙泊酚相比,瑞马唑仑起效时间缩短,呼吸、血流动力学稳定性MAP、HR、SpO_(2)增加,术后苏醒时间缩短,注射痛、低血压、心动过缓、躁动发生率均降低,差异均有统计学意义(P<0.05);而两者的低氧血症、恶心呕吐、呼吸抑制发生率等差异无统计学意义(P>0.05)。结论:瑞马唑仑相较于丙泊酚引起的血流动力学波动更小,用于全麻诱导与维持可获得较为满意的镇静效果,具有较高的有效性和安全性。

Objective:To present a systematic evaluation of the efficacy and safety of remazolam and propofol in general anesthesia during surgery in patients.Methods:A systematic search of China National Knowledge Infrastructure(CNKI),China Biomedical Literature Database,Wanfang Database,VIP Database,Web of Science,PubMed,Embase and Cochrane Library were performed from the establishment of the database to April 2022 to collect the literatures about the application of remazolam and propofol in general anesthesia surgery.The quality evaluation and data extraction of the included literatures were carried out,and the RevMan 5.3 software was used for Meta-analysis.Results:17 articles were selected and 1983 patients were included in the study.The results of Meta-analysis showed that compared with propofol,rematazolam had a shorter onset time,increased respiratory and hemodynamic stability MAP,HR,SpO_(2),shortened awakening time,and decreased incidence of injection pain,hypotension,bradycardia,and agitation,the difference was statistically significant(P<0.05).There were no significant differences of the incidence of hypoxemia,nausea and vomiting,and the incidence of respiratory depression(P>0.05).Conclusion:Compared with propofol,rematazolam causes less hemodynamic fluctuations,which can be used to induce and maintain general anesthesia and obtain satisfactory sedation effect with high efficacy and safety.