瑞马唑仑复合阿芬太尼用于经皮肾穿刺活检术患儿的效果

Effect of Remimazolam Combined with Alfentanil in Children Undergoing Percutaneous Renal Biopsy

目的观察瑞马唑仑复合阿芬太尼用于经皮肾穿刺活检术患儿的效果。方法选择2022年12月至2023年5月在江西省儿童医院拟行经皮肾穿刺活检术的患儿80例,采用随机数字表法随机分为瑞马唑仑复合阿芬太尼组(RA组)和丙泊酚复合阿芬太尼组(PA组),每组40例。记录术中血氧饱和度(SpO_(2))下降(SpO_(2)<93%)、肺通气不足、呼吸道梗阻、呼吸暂停、心动过缓、低血压、体动反应及瑞马唑仑或丙泊酚注射痛的发生情况;麻醉诱导前(T_(0))、麻醉诱导后(T_(1))、手术开始时(T_(2))、手术结束时(T_(3))的心率(HR)、平均动脉压(MAP);阿芬太尼用量、术后苏醒时间、术者满意度;术后苏醒期躁动、恶心呕吐及嗜睡的发生情况。结果与T_(0)时比较,T_(1)时两组患儿HR明显减慢,MAP明显降低(P<0.05);T_(0)-T_(3)时两组患儿HR、MAP差异无统计学意义。与PA组比较,RA组患儿术中SpO_(2)下降、肺通气不足、呼吸道梗阻和注射痛发生率明显减少(P<0.05)。两组患儿呼吸暂停、心动过缓、低血压、体动反应发生率差异无统计学意义。与PA组比较,RA组患儿苏醒时间明显缩短(P<0.05)。两组患儿阿芬太尼用量和术者满意度差异无统计学意义。两组术后无一例发生苏醒期躁动、恶心呕吐及嗜睡等不良反应。结论与丙泊酚复合阿芬太尼相比,瑞马唑仑复合阿芬太尼可有效降低经皮肾穿刺活检术中患儿SpO_(2)下降、肺通气不足及呼吸道梗阻的发生率,减少注射痛,缩短苏醒时间。

Objective To observe the effect of remimazolam combined with alfentanil in children undergoing percutaneous renal biopsy.Methods 80 children undergoing percutaneous renal biopsy at Jiangxi Children's Hospital from December 2022 to May 2023,were randomly divided into two groups with 40 cases each:remimazolam combined with alfentanil group(group RA)and propofol combined with alfentanil group(group PA).The incidence of oxygen saturation(SpO_(2))decrease(SpO_(2)<93%),pulmonary ventilation insufficiency,respiratory obstruction,apnea,bradycardia,hypotension,body movement reaction during operation and pain caused by remidazolam or propofol injection were recorded.Heart rate(HR),mean arterial pressure(MAP)were recorded before induction of anesthesia(T_(0)),after induction of anesthesia(T_(1)),at the beginning of operation(T_(2)),at the end of operation(T_(3)).The dosage of alfentanil,postoperative recovery time,and operator satisfaction were recorded.The incidence of postoperative adverse reactions such as restlessness during recovery,postoperative nausea and vomiting,and drowsiness were recorded.Results Compared with T_(0),HR and MAP were increased significantly in both group RA and group PA at T_(1)(P<0.05).There was no significant difference in HR and MAP between group RA and group PA at T_(0)-T_(3).Compared with PA group,the incidence of SpO_(2)decrease,pulmonary ventilation insufficiency,respiratory obstruction and injection pain in RA group were significantly reduced(P<0.05).There was no significant difference in the incidence of apnea,bradycardia,hypotension and body movement reaction between the two groups.Compared with PA group,the recovery time of children in RA group was significantly shorter(P<0.05).There was no significant difference between the two groups in the dosage of alfentanil and operator satisfaction.There were no adverse reactions such as restlessness during recovery,postoperative nausea and vomiting,and drowsiness in the two groups after operation.Conclusion Compared with propofol combined with alfentanil,remazolam combined with alfentanil can effectively reduce the incidence of SpO_(2)decrease,pulmonary ventilation insufficiency,respiratory obstruction,injection pain,and shorten the recovery time in children undergoing percutaneous renal biopsy.