Clinical application of remimazolam besylate in intracranial aneurysm embolization
Objective:To investigate the clinical application of remimazolam besylate in patients undergoing intracranial aneurysm embolization surgery.Methods:Seventy patients of both sexes,aged 18-65 y,with body mass index(BMI)18～28 kg/m2,American Society of Anesthesiologists(ASA)physical status Ⅰ、Ⅱ or Ⅲ,scheduled for intracranial aneurysm embolization surgery,were divided into two groups using a random number table method(n=35):remimazolam besylate(group R)and propofol(group P).Propofol 2 mg/kg was given intravenously in group P,and remimazolam besylate 0.2 mg/kg was given intravenously in group R during anesthesia induction.Alfentanil 10 μg/kg and micuronium chloride 0.2 mg/kg were given in both groups after the patients lost consciousness.After laryngeal mask placement,propofol 4～8 mg·kg-1·h-1,remimazolam besylate 0.3～1.0 mg kg-1·h-1and remifentanil 0.1 μg kg-1·min-1 and micuronium chloride 0.2 mg kg-1·h-1were injected by pump in group P and group R.Recorded blood pressure and heart rate,BIS values,and modified Observer's Assessment of Alert/Sedation(mOAA/S)before anesthesia induction(T0),when placing a laryngeal mask(T1),5 min after laryngeal mask insertion(T2),at the time of anesthesia withdraw(T3),at the time of laryneal mask removal(T4)and 5 min after laryngeal mask removal(T5).The time from the start of anesthesia to the withdrawal of anesthesia(anesthesia time),the time from the beginning of surgery to the end of surgery(operation time),and the time from the end of administration to recovery(recovery time),and the time from the end of administration to the removal of laryngeal mask(extubation time)were recorded.The intraoperative and postoperative adverse events or reactions were recorded,such as bradycardia,hypotension,injection pain,dizziness and drowsiness.The intraoperative awareness was recorded using the Brice questionnaire method.Results:Compared with T0,in group P,systolic blood pressure(SBP)decreased significantly at Ti,T2,T3 and T4(P＜0.05),and diastolic blood pressure(DBP)decreased significantly at T1,T2 and T3(P＜0.05),there was a decreased significantly in heart rate at T1,T2 and T3(P＜0.05);In group R,SBP decreased significantly at T1,T2,T3 and T5(P＜0.05),and DBP decreased significantly at Ti,T2 and T3(P＜0.05),There was no significant decrease in HR at T1,T4,and T5(P＜0.05).Compared with group P,DBP increased in group R at T2 and T5(P＜0.05),and heart rate increased at T1,T2,T3 and T4(P＜0.05).There was no significant difference in anesthesia time and operation time between the two groups(P＞0.05).Compared with group P,the wake-up time was shortened in group R and the extubation time was shortened in group R(P＜0.05).Compared with group P,group R had no injection pain and a lower overall incidence of adverse reactions(P＜0.05).There was no significant difference in the incidence of intraoperative hypotension,remedial sedation,dizziness,drowsiness,and nausea between the two groups(P＞0.05);and there were no bradycardia,hypertension and intraoperative awareness occurred in the two groups.Conclusion:Rimazolam besylate can be safely used for anesthesia during intracranial aneurysm embolization surgery,and there is no significant effect on heart rate when induced,and there is no injection pain.
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