瑞马唑仑与右美托咪定、咪达唑仑、丙泊酚在非全身麻醉辅助镇静中的对比分析研究进展

Advances in the Comparative Analysis of Remimazolam and Dexmedetomidine, Midazolam, and Propofol in Non-General Anesthesia-Assisted Sedation

全身麻醉是目前临床麻醉工作中应用最为普遍的麻醉方式,但因实施全身麻醉过程中应用的麻醉药品较多,对于一些单纯的上或下肢的手术或合并全身麻醉禁忌症,不需要或不能接受全身麻醉的病人,椎管内麻醉和神经阻滞这些非全身麻醉方法仍是临床麻醉中不可缺少的麻醉方式,以往非全身麻醉围手术期管理的理念仅仅只关注于术中镇痛忽视了术中镇静。随着中国经济的飞速增长,人民生活的水平不断提高以及麻醉学科的迅速发展,患者及其家属对围手术期的舒适化过程提出了更高要求,同时麻醉医生对临床麻醉工作的要求也不断提高,麻醉医生不光要关注围手术期的痛疼还需考虑到患者的心理变化,通过辅助一些镇静药物使患者达到睡眠状态,来帮助患者舒适的度过围手术期这一医疗过程。在过去的很长一段时间里,麻醉镇静药物几乎没有更新,直到一种新型苯二氮卓类药物甲苯磺酸瑞马唑仑的上市,给麻醉医生在围手术期镇静药物的选择上增加了一种选择,本文综述的重点是总结瑞马唑仑在临床应用中的最新进展,以及瑞马唑仑和其他几种常见的镇静药物在非全身麻醉中辅助镇静的优缺点对比,为临床麻醉工作提供一些参考。

General anesthesia is the most commonly used anesthesia method in clinical anesthesia at present. However, due to the large number of narcotic drugs used in the process of general anesthesia, for some patients who do not need or cannot receive general anesthesia due to simple upper or lower extremity surgery or contraindications of general anesthesia, Intra-spinal anesthesia and nerve block are still indispensable anesthesia methods in clinical anesthesia. The previous concept of perioperative management of non-general anesthesia only focused on intraoperative analgesia and ignored intraoperative sedation. With the rapid growth of China’s economy, the continuous improvement of people’s living standards and the rapid development of anesthesia, patients and their families have put forward higher requirements for the perioperative comfort process, and anesthesiologists’ requirements for clinical anesthesia work have also been increasing. Anesthesiologists should not only pay attention to the perioperative pain but also take into account the psychological changes of patients. By assisting some sedative drugs to make patients sleep, to help patients comfortably through the perioperative period of this medical process. For a long time in the past, anesthetic sedation drugs have hardly been updated, until a new benzodiazepine drug remimazolam toluene sulfonate came on the market, giving anesthesiologists an additional option in the choice of perioperative sedation drugs. The focus of this review is to summarize the latest progress of remimazolam in clinical application. The advantages and disadvantages of remimazolam and other common sedative drugs in non-general anesthesia were compared to provide some references for clinical anesthesia work.