中国临床药学杂志

目的 观察瑞马唑仑在乳腺良性手术麻醉应用中的有效性与安全性。方法 选择在医院行乳腺良性手术的患者60例,随机分为2组(n=30):丙泊酚组和瑞马唑仑组。2组均予舒芬太尼(0.3～0.4μg·kg^-1,iv)和苯磺顺阿曲库铵(0.1 mg·kg^-1,最大剂量6 mg,iv),3 min后置入喉罩麻醉维持:丙泊酚组予丙泊酚4～10μg·kg^-1·h^-1,瑞芬太尼0.1～0.2μg·kg^-1·min^-1;瑞马唑仑组予瑞马唑仑1 mg·kg^-1·h^-1,瑞芬太尼0.1～0.2μg·kg^-1·min^-1。观察2组患者麻醉质量(诱导成功率、睫毛反射消失时间、注射痛发生率、术中知晓率),血流动力学变化以及术后恢复质量(拔除喉罩时间、复苏室停留时间、术后QoR40质量评分、术后恶心呕吐)。结果 与丙泊酚组比较,瑞马唑仑组麻醉诱导和维持血流动力学更稳定(P <0.05),且注射痛发生率更低(P <0.05),睫毛反射消失时间更长(P <0.05)。2组患者诱导成功率、拔除喉罩时间、复苏室停留时间、术后恶心呕吐发生率、术中知晓率、术后24 h恢复质量均差异无统计学意义(P> 0.05)。结论 瑞马唑仑可为乳腺良性手术提供较为良好的麻醉镇静,不良反应少。

AIM To observe the efficacy and safety of remimazolam for anesthesia in benign breast surgery.METHODS A total of 60 patients of benign breast surgery in our hospital were selected and randomly divided into 2 groups(n=30): propofol group and remimazolam group. Both groups were intravenously injected with 0.3-0.4 μg·kg^-1 sufentanil and 0.1 mg·kg^-1 cisatracurium besilate(maximum dose: 6 mg), and the laryngeal mask was placed and maintained after 3 minutes. Propofol(4-10 μg·kg^-1·h^-1) and remifentanil(0.1-0.2 μg·kg^-1·min^-1) were given in propofol group, and remimazolam(1 mg·kg^-1·h^-1) and remifentanil(0.1-0.2 μg·kg^-1·min^-1) were given in remimazolam group. Anesthesia quality(induction success rate, disappearance time of eyelash reflex, injection pain, and intraoperative awareness), hemodynamic changes and postoperative recovery quality(time to remove laryngeal mask, time of stay in post anesthesia care unit, QoR40 quality scores, postoperative nausea and vomiting) were observed in 2 groups. RESULTS Compared with propofol group, the anesthesia induction and maintenance hemodynamics were more stable(P < 0.05), the incidence of injection pain was lower(P < 0.05), and the disappearance time of eyelash reflex was longer(P < 0.05) in remimazolam group. There were no significant differences in induction success rate, time of laryngeal mask removal, stay in post anesthesia care unit, incidence of postoperative nausea and vomiting, intraoperative awareness and QoR40 quality scores between 2 groups(P > 0.05). CONCLUSION Remimazolam can provide a good anesthesia and sedation for benign breast surgery anesthesia with few adverse reactions.