瑞马唑仑联合不同剂量丙泊酚对腹腔镜下全子宫切除术患者麻醉诱导镇静及不良反应的影响

Effects of Remazolam Combined with Different Doses of Propofol on Seda⁃tion and Adverse Reactions in Patients Undergoing Total Laparoscopic Hys⁃terectomy

目的探究瑞马唑仑联合不同剂量丙泊酚对腹腔镜下全子宫切除术患者麻醉诱导镇静及不良反应的影响。方法选取2021年4月至2023年8月行腹腔镜下全子宫切除术患者96例,采用随机数字表法分为A、B组各48例,患者均采用瑞马唑仑联合丙泊酚进行麻醉诱导,其中A组丙泊酚剂量为0.5 mg/kg,B组丙泊酚剂量为1.0 mg/kg。比较2组围术期指标、麻醉诱导情况,麻醉诱导开始时(T0)、机械通气前即刻(T1)及机械通气3 min(T2)时血流动力学指标及术中术后不良反应发生情况。结果2组手术时间、术中出血量、补液量比较差异均无统计学意义(P>0.05)。B组麻醉诱导时间短于A组,丙泊酚补救患者少于A组(P<0.05,P<001)。2组T0~T2时心率(HR)、平均动脉压(MAP)、脑电双频指数(BIS)均呈下降趋势(P<0.05),但2组同一时间点HR、MAP、BIS比较无明显差异(P>0.05)。B组总不良反应发生率为60.42%高于A组的25.00%(P<001)。结论瑞马唑仑联合小剂量丙泊酚在腹腔镜下全子宫切除术中可发挥较好的镇静作用和血流动力学稳定作用,丙泊酚剂量为1.0 mg/kg时镇静作用更佳,但不良反应发生率较高。

Objective To investigate the effects of Remazolam combined with different doses of Propofol on sedation and adverse reactions in patients induced by anesthesia during total laparoscopic hysterectomy(TLH).Methods A total of 96 patients undergoing TLH from April 2021 to August 2023 were selected and divided into group A(n=48)and group B(n=48)according to random number table method.All patients were induced with Remazolam combined with Propofol.The dosage of Propofol was 0.5 mg/kg in group A and 1.0 mg/kg in group B.Perioperative indexes,anesthesia induction,hemo-dynamic indexes at the beginning of anesthesia induction(T0),immediately before mechanical ventilation(T1)and at 3 min after mechanical ventilation(T2),and the occurrence of intraoperative and postoperative adverse reactions were compared be-tween the two groups.Results There were no significant differences in the duration of operation,intraoperative blood loss and fluid replenishment between the two groups(P>0.05).The time of anesthesia induction in group B was shorter than that in group A,and rescue with Propofol in group B was less than that in group A(P<0.05,P<0.01).Heart rate(HR),mean arterial pressure(MAP)and bispectral index(BIS)of the two groups showed a decreasing trend at T0-T2(P<0.05),but there were no significant differences in HR,MAP and BIS values between the two groups at the same time point(P>0.05).The total adverse reaction rate of group B(60.42%)was higher than that of group A(25.00%)(P<0.01).Con-clusion Remazolam combined with low-dose Propofol can play a better sedative and hemodynamic role in TLH,and the seda-tive effect is better when the dosage of Propofol is 1.0 mg/kg,but the incidence of adverse reactions is higher.