模拟丙泊酚Marsh模式靶控输注瑞马唑仑在全麻诱导和维持的可行性研究

Feasibility of remimazolam mimic propofol Marsh mode target-controlled infusion during anesthesia

目的:评价模拟丙泊酚Marsh模式靶控输注瑞马唑仑对腹腔镜胆囊手术患者麻醉诱导和维持的可行性临床应用研究。方法:择期行腹腔镜胆囊手术患者80例,随机分为丙泊酚组(P组)和瑞马唑仑组(R组),每组各40例,麻醉诱导和维持分别靶控输注丙泊酚和瑞马唑仑(Marsh模式,血浆靶浓度)。记录意识消失时间,诱导插管前(T0)、插管后即刻(T1)、插管后3 min(T2)、气腹即刻(T3)、术中30 min(T4)、术毕(T5)的心率(HR)、平均动脉压(MAP)、脑电双频指数(BIS);记录注射痛、术毕气管拔管时间和术后不良反应。结果:与P组比较,R组意识消失时间短(P<0.05),注射痛、术中低血压和心动过缓的发生率低(P<0.05),但术后拔管时间延长(P<0.05)。结论:模拟丙泊酚Marsh模式靶控输注瑞马唑仑用于全麻诱导和维持,安全有效可行,不良反应少,且生命体征平稳。

AIM:To evaluate the feasibility of Marsh target-controlled infusion of simulated propofol with remimazolam for induction and maintenance of anesthesia in patients undergoing laparoscopic gallbladder surgery.METHODS:A total of 80 patients undergoing elective laparoscopic gallbladder surgery were randomly divided into propofol group(Group P)and remimazolam group(Group R),with 40 cases in each group.Anesthesia was induced and maintained by target-controlled infusion of propofol and remimazolam respectively(Marsh mode,plasma target concentration).The time of loss of consciousness was recorded,and HR,MAP and BIS were induced before intubation(T0),immediately after intubation(T1),3min after intubation(T2),immediately after pneumoperitoneum(T3),30min during surgery(T4),and after surgery(T5).Injection pain,tracheal extubation time and postoperative adverse reactions were recorded.RESULTS:Compared with Group P,the loss of consciousness in Group R was shorter(P<0.05),the incidence of injection pain,intraoperative hypotension and bradycardia was lower(P<0.05),but the postoperative extubation time was longer(P<0.05).CONCLUSION:Remimazolam can be applied to the Marsh mode of propofol,and Remimazolam mimic target-controlled infusion(Marsh mode)has a good effect and safety on inducing and maintaining sedation under general anesthesia,as well as the vital signs are stable.