瑞马唑仑复合阿芬太尼在日间手术麻醉中安全性和有效性的研究

Safety and efficacy of remimazolam combined with alfentanil in anesthesia in daytime operation

目的探讨瑞马唑仑复合阿芬太尼在日间手术麻醉中安全性和有效性。方法选取秦皇岛军工医院行日间手术麻醉的100例患者,随机将其分为对照组与研究组,每组50例。对照组联合丙泊酚复合阿芬太尼麻醉,研究组联合瑞马唑仑复合阿芬太尼麻醉,术中发生体动时分别加注丙泊酚或瑞马唑仑,直至体动消失。记录两组患者进入手术室至出手术室时心率(heart rate,HR)、血氧饱和度(oxygen saturation,SpO_(2))、平均动脉压(mean arterial pressure,MBP)。采用警觉/镇静评分(alertness/sedation score,OAA/S)评估两组患者镇静状态。记录两组患者术中体动比例、苏醒时间、恢复室停留时间及不良反应发生率。结果研究组患者手术开始时(T1)至手术结束时(T3)时HR、MAP、SpO_(2)及OAA/S评分与术前(T0)比较差异无统计学意义(P>0.05),T1~T3时对照组HR、MAP、SpO_(2)及OAA/S评分较T0显著降低(P<0.05),研究组患者T1、术中(T2)、T3时HR、MAP、SpO_(2)及OAA/S评分明显高于对照组(P<0.05)。研究组患者体动比例、苏醒时间与恢复室停留时间均显著少于或短于对照组(P<0.05)。研究组患者嗜睡、低血压及呼吸抑制等不良反应发生率显著低于对照组(P<0.05)。结论与丙泊酚相比,日间手术患者予以瑞马唑仑复合阿芬太尼麻醉,更有助于维持生命体征稳定,缩短术后苏醒时间,降低不良反应发生率。

Objective To investigate the safety and efficacy of remimazolam combined with fentanyl in anesthesia in daytime operation.Methods A total of 100 patients undergoing anesthesia in daytime operation in Qinhuangdao Military Industry Hospital were selected and randomly divided into control group and research group,with 50 cases in each group.The control group was given propofol combined with fentanyl for anesthesia,and the research group was given remimazolam combined with fentanyl for anesthesia.Propofol or remazolam was added when body movement occurred during the operation until the body movement disappeared.Heart rate(HR),oxygen saturation(SpO_(2))and mean arterial pressure(MBP)from entering the operating room to leaving the operating room were recorded between two groups.Alertness/sedation score(OAA/S)was used to evaluate the sedation state of the two groups.The proportion of intraoperative body movement,recovery time,residence time in recovery room and incidence of adverse reactions were recorded.Results There was no significant difference in HR,MAP,SpO_(2) and OAA/S scores of the group from the beginning of operation(T1)to the end of operation(T3),as compared with those before operation(T0)(P>0.05).HR,MAP,SpO_(2) and OAA/S scores of the control group at T1-T3 were significantly lower than those of T0(P<0.05).The scores of HR,MAP,SpO_(2) and OAA/S at T1,T2 and T3 were higher in research group than in the control group(P<0.05).The body movement ratio,recovery time and residence time in the recovery room were smaller or shorter in the research group than in the control group(P<0.05).The incidence of adverse reactions such as drowsiness,hypotension and respiratory depression in the research group was significantly lower than that in the control group(P<0.05).Conclusion Compared with propofol,remimazolam combined with fentanyl for anesthesia is more helpful to maintain the stability of vital signs,shorten the postoperative recovery time and reduce the incidence of adverse reactions.