瑞马唑仑复合吸入麻醉用于烧伤患儿清创换药术中的效果观察

Effect observation of Remazolam combined with inhalation anesthesia in debridement and dressing change of children with burns

目的 探讨瑞马唑仑复合吸入麻醉用于烧伤患儿清创换药术中的临床效果。方法 选取2022年6月—2022年9月郑州市第一人民医院择期行烧伤清创换药术的患儿72例,随机分为对照组和试验组两组(n=36),分别采用丙泊酚注射液(3 mg/kg)联合盐酸纳布啡注射液(0.2 mg/kg)和苯磺酸瑞马唑仑注射液(0.4 mg/kg)联合盐酸纳布啡注射液(0.2 mg/kg)进行麻醉诱导。患儿入睡后,给予吸入浓度为8%的七氟烷,患儿下颌松弛后置入相应规格的喉罩,并需浓度为3%~5%的七氟烷维持麻醉。比较两组围手术期相关指标、T1、T2、T3时间点心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)水平、术中和术后不良事件发生率。结果 与对照组相比较,试验组诱导起效时间较短,但两组在术后苏醒时间和手术、PACU停留时间方面比较差异无统计学意义(P>0.05);与对照组相比较,对照组T1、T2、T3时间点HR、MAP、SpO2水平波动幅度较小(P<0.05);与观察组术中和术后不良事件发生率(2.77%、2.77%)比较,对照组术中和术后不良事件发生率(16.66%、25.00%)明显降低(P<0.05)。结论 将瑞马唑仑复合吸入麻醉用于烧伤患儿清创换药术中,起效迅速且镇静效果好,不会对患儿的呼吸和循环系统造成不良影响,且有利于降低术中和术后不良事件发生率。

Objective To investigate the clinical effect of Remazolam combined with inhalation anesthesia in debridement and dressing change of children with burns. Methods A total of 72 children who underwent burn debridement and dressing change in the First People's Hospital of Zhengzhou from June 2022 to September 2022 were selected and randomly divided into control group and experimental group(n=36). Propofol injection(3 mg/kg) combined with nalbuphine hydrochloride injection(0.2 mg/kg) and Remazolam benzoate injection(0.4 mg/kg) combined with Nalbuphine hydrochloride injection(0.2 mg/kg) were used to induce anesthesia, respectively. After the children fell asleep, they were given sevoflurane with an inhalation concentration of 8%. After the children's jaw was relaxed, a laryngeal mask of the corresponding specifications was inserted, and sevoflurane with a concentration of 3% to 5% was required to maintain anesthesia. The perioperative indexes, heart rate(HR), mean arterial pressure(MAP), blood oxygen saturation(SpO_(2)) and the incidence of intraoperative and postoperative adverse events were compared between the two groups at T_1, T_(2) and T_(3) time points.Results Compared with the control group, the induction onset time of experimental group was shorter, but there was no significant difference in postoperative recovery time, operation and PACU residence time between the two groups(P>0.05). Compared with the control group, the fluctuation of HR, MAP and SpO_(2) levels at T_1, T_(2) and T_(3) time points in experimental groups was smaller(P<0.05). Compared with the experimental group(2.77%, 2.77%), the incidence of intraoperative and postoperative adverse events in control group(16.66%, 25.00%) was significantly decreased(P<0.05).Conclusion Remazolam combined with inhalation anesthesia in debridement and dressing change of children with burns has rapid effect and good sedative effect. It will not cause adverse effects on the respiratory and circulatory system of children, and is beneficial to reduce the incidence of intraoperative and postoperative adverse events.