甲苯磺酸瑞马唑仑与丙泊酚全身麻醉过程中脑电双频指数值的比较

The values of BIS in remimazolam versus propofol for general anesthesia

目的比较瑞马唑仑与丙泊酚全麻诱导与维持过程中脑电双频指数(bispectral index,BIS)的变化。方法择期全麻下行腹腔镜短小手术患者79例,随机分为两组,丙泊酚组(P组)和甲苯磺酸瑞马唑仑组(R组)。诱导及维持:P组,丙泊酚;R组,瑞马唑仑。主要指标:不同时间点BIS值。次要指标:BIS值大于60的发生率;需要补救镇静药物及术中体动的次数、术中知晓/回忆的发生率;不同时间点平均动脉压(MAP)、心率(HR);意识消失时间、插管前BIS达最低值的时间、清醒时间;术中不良反应的发生率。结果与P组相比,在T1、T2、T3、T4、T5、T6时间点,R组BIS值较高(P<0.001),且有更多的患者BIS值大于60(P<0.05);在T9、T10时间点,R组BIS值较低(P<0.05)。两组患者均未使用补救镇静药物,均未出现术中体动、术中知晓/回忆。与P组相比,R组患者意识消失时间、插管前BIS达最低值时间、意识清醒时间延长(P<0.001);低血压、心动过缓的发生率降低,差异均有统计学意义(P<0.05)。结论在瑞马唑仑与丙泊酚安全、有效的完成全身麻醉诱导与维持过程中,瑞马唑仑组BIS值要高于丙泊酚组,并且有更多的患者BIS值大于60。

Objective:To compare the changes of the values of BIS in Remimazolam versus propofol for general anesthesia Methods:Seventy-nine patients undergoing short laparoscopic surgery under general anesthesia were randomly divided into two groups.Induction and maintenance was that group C contained propofol,while group R contained remimazolam.The primary objective was to show BIS values at different time points.Secondary outcomes were the incidence of BIS>60,intraoperative awareness/recall,use of rescue sedative agents and body movement,the MAP and HR at different time points,the times to loss of consciousness,recovery and the lowest value of BIS before intubation,and incidence of adverse reactions.Results:Compared with group P,values of BIS in group R were higher at T1,T2,T3,T4,T5,T6(P<0.001)and lower at T9 and T10(P<0.05).The incidence of BIS>60 in group R was increased(P<0.05).There were noobserved intraoperative awareness/recall,use of rescue sedative agents and body movement.Compared with group P,the time of loss of consciousness,reaching the lowest value before intubation and consciousness were extended.(P<0.001),and the incidences of hypotension and bradycardia were decreased(P<0.05).Conclusion:In the process of safe and effective induction and maintenance of general anesthesia with remimazolam and propofol,the BIS value of remimazolam group is higher than that of propofol group,and there are more patients whose BIS value is more than 60.