瑞马唑仑对全身麻醉下腹腔镜胆囊切除术患者麻醉效果的影响

Influence of remimazolam on anesthesia effect in patients undergoing laparoscopic cholecystectomy under general anesthesia

目的探究瑞马唑仑对全身麻醉下腹腔镜胆囊切除术(LC)患者麻醉效果的影响。方法70例全身麻醉下LC患者为研究对象,依据随机数字表法分为观察组与对照组,各35例。对照组采用咪达唑仑+舒芬太尼+顺式阿曲库铵进行术中麻醉诱导,观察组采用瑞马唑仑+舒芬太尼+顺式阿曲库铵进行术中麻醉诱导。对比两组血流动力学指标、恢复时间、术后应激指标[去甲肾上腺素(NE)、皮质醇(Cor)、胰岛素(INS)、C肽(C-P)]及不良反应发生情况。结果诱导时(T1)、插管后即刻(T2)、插管后(T3),观察组心率(HR)、平均动脉压(MAP)水平均低于对照组,差异有统计学意义(P<0.05)。观察组麻醉苏醒时间(6.13±1.24)min、拔管时间(11.02±2.01)min、麻醉监护室停留时间(22.31±6.25)min均短于对照组的(9.77±1.62)、(14.56±2.35)、(28.66±7.15)min,差异有统计学意义(P<0.05)。术后24 h,观察组NE(42.65±6.32)ng/ml、Cor(92.46±10.37)ng/ml、INS(13.52±1.79)nmol/L、C-P(0.85±0.12)nmol/L均低于对照组的(65.23±8.27)ng/ml、(127.34±15.64)ng/ml、(20.34±3.32)nmol/L、(1.70±0.23)nmol/L,差异有统计学意义(P<0.05)。观察组不良反应发生率20.00%低于对照组的45.71%,差异有统计学意义(P<0.05)。结论将瑞马唑仑用于全身麻醉下LC诱导麻醉中效果显著,安全性较高,可加速患者麻醉后苏醒,减轻生理应激反应,值得推广应用。

Objective To investigate the influence of remimazolam on anesthesia effect in patients undergoing laparoscopic cholecystectomy(LC)under general anesthesia.Methods A total of 70 patients with LC undergoing general anesthesia were divided into observation group and control group according to the random numerical table,with 35 cases in each group.The control group received midazolam+sufentanil+cis-atracurium for intraoperative anesthesia induction,while the observation group received remimazolam+sufentanil+cisatracurium for intraoperative anesthesia induction.The hemodynamic indexes,recovery time,postoperative stress indexes[norepinephrine(NE),cortisol(Cor),insulin(INS),C-peptide(C-P)],and occurrence of adverse reactions were compared between the two groups.Results At the time of induction(T1),immediately after intubation(T2)and after intubation(T3),the levels of heart rate(HR)and mean arterial pressure(MAP)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The recovery time of anesthesia(6.13±1.24)min,the extubation time(11.02±2.01)min,and the stay time in the anesthesia monitoring room(22.31±6.25)min in the observation group were shorter than(9.77±1.62),(14.56±2.35),and(28.66±7.15)min in the control group,and the differences were statistically significant(P<0.05).At 24 h after surgery,the NE(42.65±6.32)ng/ml,Cor(92.46±10.37)ng/ml,INS(13.52±1.79)nmol/L,C-P(0.85±0.12)nmol/L in the observation group were lower than(65.23±8.27)ng/ml,(127.34±15.64)ng/ml,(20.34±3.32)nmol/L,(1.70±0.23)nmol/L in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 20.00%,which was lower than 45.71%in the control group,and the difference was statistically significant(P<0.05).Conclusion Remimazolam is effective and safe in LC induced anesthesia under general anesthesia,which can accelerate the recovery of patients after anesthesia and reduce physiological stress reaction,and is worthy of promotion and application.