瑞马唑仑复合小剂量丙泊酚用于麻醉诱导时镇静的效果

Efficacy of remimazolam combined with low-dose propofol for sedation during induction of anesthesia

目的评价瑞马唑仑复合小剂量丙泊酚用于麻醉诱导时镇静的效果。方法择期行腹腔镜胆囊切除术患者228例,性别不限,年龄18~64岁,BMI 19~35 kg/m^(2),ASA分级Ⅰ~Ⅲ级。采用随机数字表法分为2组(n=114):瑞马唑仑复合小剂量丙泊酚组(R组)和丙泊酚组(P组)。麻醉诱导:R组静脉注射舒芬太尼0.3μg/kg、瑞马唑仑0.3 mg/kg、丙泊酚0.5 mg/kg和米库氯铵0.2 mg/kg;P组静脉注射舒芬太尼0.3μg/kg、丙泊酚2 mg/kg和米库氯铵0.2 mg/kg,BIS值≤50时行气管插管术。于诱导前(T0)、气管插管前即刻(T1)、气管插管后1 min(T2)和3 min(T3)时记录MAP及HR。记录2组麻醉诱导时间、低血压和心动过缓的发生情况。结果2组T0时MAP及HR比较差异无统计学意义(P>0.05)。与T0时比较,T1~3时2组MAP和P组HR降低(P<0.01)。与P组比较,R组麻醉诱导时间延长,低血压和心动过缓发生率降低(P<0.05)。结论瑞马唑仑复合小剂量丙泊酚用于麻醉诱导时镇静效果优于单用丙泊酚。

Objective To evaluate the efficacy of remimazolam combined with low-dose propofol for sedation during induction of anesthesia.Methods A total of 228 patients of both sexes,aged 18-64 yr,with body mass index of 19-35 kg/m^(2),of American Society of Anesthesiologists physical statusⅠ-Ⅲ,undergoing elective laparoscopic cholecystectomy,were divided into 2 groups(n=114 each)by a random number table method:remimazolam combined with low-dose propofol group(group R)and propofol group(group P).Anesthesia was induced with intravenous injection of sufentanil 0.3μg/kg,remimazolam 0.3 mg/kg,propofol 0.5 mg/kg and micuronium 0.2 mg/kg in group R,and sufentanil 0.3μg/kg,propofol 2 mg/kg and micuronium 0.2 mg/kg in group P.Endotracheal intubation was performed when bispectral index value≤50.Before induction(T0),immediately before intubation(T1),at 1 min(T2)and 3 min(T3)after intubation,mean arterial pressure(MAP)and heart rate(HR)were recorded.The anesthesia induction time and the incidence of hypotension and bradycardia were recorded in the two groups.Results There was no significant difference in MAP and HR at T0 between the two groups(P>0.05).Compared with the value at T0,MAP in two groups and HR were significantly decreased at T1-3 in group P(P<0.01).Compared with group P,the anesthesia induction time was significantly prolonged,and hypotension and bradycardia was decreased in group R(P<0.05).Conclusion The combination of remimazolam and low-dose propofol exerts better efficacy for sedation during induction of anesthesia than propofol alone.