不同剂量的瑞马唑仑对腹腔镜胆囊切除术患者全麻诱导期心血管反应的影响

Effect of Different Doses of Remazolam on Cardiovascular Responses during Induction of General Anesthesia in Patients Undergoing Laparoscopic Cholecystectomy

目的:观察不同剂量瑞马唑仑对腹腔镜胆囊切除术患者全麻诱导期心血管反应的影响。方法:前瞻性选取2021年1月至2022年2月期间在我院行腹腔镜胆囊切除术患者122例,采用简单随机设计方案,依据统计学软件生成的随机数字表将患者分为两组。对照组采用0.1mg/kg剂量瑞马唑仑进行麻醉诱导,观察组采用0.2mg/kg剂量瑞马唑仑进行麻醉诱导。检测两组血流动力学的差异,比较两组麻醉情况和不良反应情况。结果:入室(T0)时,两组血糖水平比较,差异无统计学意义(P>0.05)。两组血糖水平于麻醉插管后1min(T1)、插管后5min(T2)时高于T0时,观察组T1、T2时血糖均低于对照组(P<0.05)。T0时,两组血流动力学比较,差异无统计学意义(P>0.05)。对照组心率(HR)、平均动脉压(MAP)水平于T1、T2时高于T0时(P<0.05)。观察组于T1时HR、MAP水平高于T0时,而T2时HR、MAP与T0时比较,差异无统计学意义(P>0.05)。观察组T1、T2时HR、MAP水平均低于对照组(P<0.05)。观察组麻醉起效时间、麻醉后监测治疗室(PACU)停留时间短于对照组,而苏醒时间、拔管时间与对照组比较,差异无统计学意义(P>0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:腹腔镜胆囊切除术中采用0.2mg/kg剂量瑞马唑仑进行麻醉诱导可稳定血流动力学,减轻心血管应激反应,缩短麻醉起效时间,且不增加不良反应。

Objective:To observe the effects of different doses of Remazolam on cardiovascular responses in patients undergoing laparoscopic cholecystectomy under general anesthesia.Methods:A total of 122 patients who underwent laparoscopic cholecystectomy in our hospital from January 2021 to February 2022 were prospectively selected and divided into two groups according to the random number table generated by statistical software using a simple random design scheme.The control group was anesthetised with 0.1 mg/kg remazolam,and the observation group was anesthetised with 0.2 mg/kg Remazolam.The differences of hemodynamics between the two groups were detected,and anesthesia and adverse reactions were compared between the two groups.Results:There was no significant difference in blood glucose level between the two groups at T0(P>0.05).When the blood glucose level of the two groups was higher than T0 at 1 min(T1)and 5 min(T2)after anesthesia intubation,the blood glucose level of the observation group at T1 and T2 was lower than that of the control group(P<0.05).At T0,there was no significant difference in hemodynamics between the two groups(P>0.05).The heart rate(HR)and mean arterial pressure(MAP)levels of the control group were higher at T1 and T2 than at T0(P<0.05).The levels of HR and MAP in the observation group at T1 were higher than those at T0,but there was no statistical difference between the levels of HR and MAP at T2 and those at T0(P>0.05).The levels of HR and MAP in the observation group at T1 and T2 were lower than those in the control group(P<0.05).The onset time of anesthesia and the duration of PACU in the observation group were shorter than those in the control group,while the recovery time and extubation time had no statistical difference(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:In laparoscopic cholecystectomy,0.2mg/kg Remazolam for anesthesia induction can stabilize blood flow.