瑞马唑仑和咪达唑仑应用于冠状动脉旁路移植术患者麻醉诱导对血流动力学指标和心血管事件发生的影响

The Effects of Anesthesia Induction on Hemodynamic Indicators and Cardiovascular Events in Patients Undergoing Coronary Artery Bypass Grafting Using Remimazolam and Midazolam

目的:探究瑞马唑仑和咪达唑仑应用于冠状动脉旁路移植术(coronary artery bypass grafting,CABG)患者麻醉诱导中血流动力学指标和心血管事件情况,检验两种麻醉药物的临床质效。方法:选取厦门大学附属第一医院2020年5月—2023年5月收治的80例被诊断为冠心病且需要进行CABG的患者,将其随机分成研究组和对照组,各40例。两组均施行CABG,术前0.5 h内肌注吗啡10 mg,麻醉诱导时,对照组注射咪达唑仑0.1 mg/kg,研究组注射苯磺酸瑞马唑仑0.2 mg/kg,当BIS<60时,两组均给予静脉注射2μg/kg舒芬太尼及1 mg/kg罗库溴铵完成麻醉诱导。观察和比较两组患者的血流动力学指标、镇静指标、心血管事件发生情况等。结果:麻醉诱导前,两组心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、每搏输出量指数(SVI)指标比较,差异均无统计学意义(P>0.05);麻醉诱导后,和对照组相比,研究组HR、SBP、DBP、MAP、SVI水平均更高,BIS水平更低,进入麻醉时间更早,差异均有统计学意义(P<0.05);两组麻醉诱导后,研究组的心血管事件总发生率低于对照组,差异有统计学意义(P<0.05)。结论:在对CABG患者施行麻醉诱导时,使用瑞马唑仑作为麻醉药物在改善血流动力学指标、提升患者镇静水平、降低心血管不良事件发生率方面效果显著。

Objective:To investigate the hemodynamic parameters and cardiovascular events during anesthesia induction in patients undergoing coronary artery bypass grafting(CABG)using Remimazolam and Midazolam,and to test the clinical efficacy of the two anesthetics.Method:A total 80 patients diagnosed with coronary heart disease and requiring CABG admitted to the First Affiliated Hospital of Xiamen University from May 2020 to May 2023 were randomly divided into a study group and a control group,with 40 patients in each group.Both groups underwent CABG,with intramuscular injection of 10 mg of Morphine within 0.5 hours before surgery.During anesthesia induction,the control group was injected with 0.1 mg/kg of Midazolam,while the study group was injected with 0.2 mg/kg of Remimazolam besylate.When BIS<60,both groups were given intravenous injections of 2μg/kg of Sufentanil and 1 mg/kg of Rocuronium bromide to complete anesthesia induction.The hemodynamic indicators,sedation indicators,and occurrence of cardiovascular events between two groups of patients were observed and compared.Result:Before anesthesia induction,there were no statistically significant differences in heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),and stroke volume index(SVI)between the two groups(P>0.05);after anesthesia induction,compared with the control group,the study group had higher levels of HR,SBP,DBP,MAP and SVI,lower level of BIS and earlier onset of anesthesia,with statistically significant differences(P<0.05);after anesthesia induction in both groups,the total incidence of cardiovascular events in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:The use of Remimazolam as an anesthetic during anesthesia induction in CABG patients has significant effects in improving hemodynamic indicators,enhancing patient sedation levels,and reducing the incidence of cardiovascular adverse events.