Comparison of Anesthesia Effects of Different Doses of Remiazolam Combined with Sufentanil in Laparoscopic Cholecystectomy for Gallbladder Diseases
Objective To compare the application effect of different doses of remidazolam combined with sufentanil respectively in laparoscopic cholecystectomy(LC)under general anesthesia.Methods A total of 204 patients who planned to undergo LC under general anesthesia in the First Affiliated Hospital of Xinxiang Medical College from January 2021 to January 2023 were selected and divided into group A,group B and group C by a random number table,with 68 cases in each group.The group A was given anesthesia induction with a small dose of remidazolam(0.2 mg·kg-1)combined with sufentanil,while group B was given anesthesia induction with a large dose of remiazolam(0.3 mg·kg-1)combined with sufentanil,and group C was given anesthesia induction with propofol(2.0 mg·kg-1)combined with sufentanil.After induction,propofol combined with remifentanil was intravenous infused at a constant rate to maintain anesthesia in three groups,and rocuronium bromide was injected intermittently to maintain muscle relaxation.The hemodynamic changes of patients in the three groups before anesthesia induction and before and after intubation were observed,and the operation time,dosage of anesthetic drugs and drug addition rates after anesthesia induction/during operation were compared.The recovery time of anesthesia(including spontaneous breathing recovery time,awakening time,extubation time)after drug withdrawal,postoperative mental status and incidences of adverse events were compared among the three groups of patients.Results In the three groups,the mean arterial pressure(MAP)immediately before intubation and immediately after intubation was lower than before induction(P＜0.05),and MAP immediately after intubation was higher than immediately before intubation(P＜0.05).The heart rates(HR)immediately before intubation were lower than before induction in three groups(P＜0.05),and the HR immediately after intubation were higher than immediately before intubation in three groups(P＜0.05),and the HR immediately after intubation in group C was lower than before induction(P＜0.05).There was no statistically significant difference in MAP and HR between group A and group B at any time(P＞0.05),but the MAP and HR immediately before and after intubation in group A and group B were higher than group C(P＜0.05).There was no difference in the operation time and remifentanil dosage among the three groups(P＞0.05),but the dosage of propofol in group B and group C were less than group A(P＜0.05),and there was no difference in the propofol dosage between group B and group C(P＞0.05).The drug addition rates in group B and group C were lower than group A(P＜0.05),but there was no difference in drug addition rates between group B and group C(P＞0.05).There was no difference in the recovery time of spontaneous breathing,awakening time and extubation time between group A and group B(P＞0.05),while the recovery time of spontaneous breathing,awakening time and extubation time in group C were longer than group A and group B(P＜0.05).In the three groups,the mini-mental state examination(MMSE)scores of patients at 24 and 72 h after operation were lower than those before entering the operating room(P＜0.05),and the MMSE scores at 72 h after operation were higher than those at 24 h after operation(P＜0.05),but there was no statistically difference in the MMSE scores among the group A,group B and group C at 24 and 72 h after operation(P＞0.05).There was no statistically significant difference in the incidence rates of adverse events between group A and group B(P＞0.05),but the total incidence rates of adverse events in group A and group B were lower than group C(P＜0.05),and the incidence rate of hypotension in group A was lower than group C(P＜0.05).Conclusion Different doses of remiazolam combined with sufentanil in LC under general anesthesia have similar impact on hemodynamics,postoperative recovery,cognitive function and safety of patients.However,comparing with 0.2 mg·kg-1 remimazolam,the use of 0.3 mg·kg-1 remimazolam can reduce the additional anesthetic drugs,and the sedative effect is better,which is worthy of clinical recommendation.
万方数据
维普
