苯磺酸瑞马唑仑用于神经阻滞麻醉患者的快速镇静效果

Rapid sedative effect of Remimazolam Besylate in patients undergoing nerve block anesthesia

目的探讨苯磺酸瑞马唑仑用于神经阻滞麻醉患者的快速镇静效果。方法选取2022年1月至9月于厦门大学附属翔安医院开展神经阻滞麻醉的60例患者作为研究对象,按随机数字表法分为对照组(30例)与舒适化组(30例),对照组采用咪达唑仑联合右美托咪定进行镇静,舒适化组采用丙泊酚联合苯磺酸瑞马唑仑进行镇静。比较两组术前及术后12、24 h的疼痛情况,比较两组感觉、运动阻滞起效时间与维持时间,以及苏醒时间;比较两组麻醉前(T0)、给药后10 min(T1)、给药后30 min(T2)、术毕即刻(T3)的心率、收缩压与舒张压水平,记录两组围手术期不良反应发生情况。结果两组术前的机械疼痛阈值比较,差异无统计学意义(P>0.05),两组术后12、24h的机械疼痛阈值均高于本组术前,且舒适化组高于对照组,差异有统计学意义(P<0.05);舒适化组的感觉、运动阻滞起效时间短于对照组,感觉、运动的阻滞维持时间长于对照组,而苏醒时间短于对照组,差异有统计学意义(P<0.05);两组T0时的心率、收缩压与舒张压水平比较,差异无统计学意义(P>0.05),舒适化组T1、T2、T3时的心率低于对照组,收缩压与舒张压高于对照组,差异有统计学意义(P<0.05);两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论苯磺酸瑞马唑仑用于神经阻滞麻醉患者具有快速镇静、对血流动力学影响小、能减轻术后疼痛强度等优点,且安全性较高,值得应用与推广。

Objective To investigate the rapid sedative effect of Remimazolam Besylate in patients undergoing nerve block anesthesia.Methods From January to September 2022,a total of 60 patients undergoing nerve block anesthesia in Xiang'an Hospital of Xiamen University were selected as the research objects.According to the random number table method,they were divided into control group(30 cases)and comfort group(30 cases).The control group was sedation with Midazolam combined with Dexmedetomidine,and the comfort group was sedation with Propofol combined with Remimazolam Besylate.The pain of the two groups before operation and 12,24 h after operation were compared.The onset time and maintenance time of sensory and motor block,and recovery time were compared between the two groups.The heart rate,systolic blood pressure and diastolic blood pressure were compared between the two groups before anesthesia(T0),10 min after administration(T1),30 min after administration(T2),and immediately after the end of operation(T3).The incidence of perioperative adverse reactions in the two groups was recorded.Results There was no statistically significant difference in the mechanical pain threshold between the two groups before operation(P>0.05).The mechanical pain thresholds of the two groups at 12 and 24 hours after operation were higher than those before operation,and those of the comfort group were higher than those of the control group,and the differences were statistically significant(P<0.05).The onset time of sensory and motor block in the comfort group were shorter than those in the control group,and the maintenance time of sensory and motor block in the comfort group were longer than those in the control group,while the recovery time was shorter than that in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in heart rate,systolic blood pressure and diastolic blood pressure at T0 between the two groups(P>0.05).At T1,T2 and T3,the heart rate of the comfort group were lower than those of the control group,and the systolic blood pressure and diastolic blood pressure were higher than those of the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Remimazolam Besylate has the advantages of rapid sedation,little effect on hemodynamics,and can reduce the intensity of postoperative pain in patients with nerve block anesthesia,and has high safety,which is worthy of application and promotion.