Effect of laryngeal mask intravenous anesthesia with remimazolam combined with remifentanil in patients undergoing ureteroscopic lithotripsy
Objective To explore the effect of laryngeal mask intravenous anesthesia with remimazolam combined with remifentanil on the sedation depth and hemodynamics in patients undergoing ureteroscopic lithotripsy.Methods The clinical data of 75 patients who underwent ureteroscopic lithotripsy were retrospectively analyzed.According to different anesthesia methods,the selected patients were divided into group A(n=37)and group B(n=38).Group A received conventional laryngeal mask intravenous anesthesia,and group B was given remimazolam combined with remifentanil for laryngeal mask intravenous anesthesia.The sedation depth,anesthetic effect,hemodynamics[mean arterial pressure(MAP),heart rate(HR)and oxygen saturation(SpO2)before anesthesia induction(t0),at the time of laryngeal mask placement(t1),at the beginning of surgery(t2)and at 5 minutes after laryngeal mask removal(t3)]and the occurrence of agitation at 30 minutes,4 hours and 8 hours after surgery were compared between the 2 groups.Results There was no statistical difference in the time of loss of consciousness and Bi-spectral index(BIS)value before mechanical ventilation between the 2 groups(P>0.05).The number of intraoperative body movements,spontaneous breathing recovery time,eye opening time and speech response time in group B were significantly less or shorter than those in group A(P<0.05).Compared with at t0,the MAP and HR at t1-t3 and SpO2 at t3 in group A were significantly decreased(P<0.05),the MAP and HR in group B were significantly reduced at t1-t3(P<0.05),and the MAP and HR in group B were significantly higher than those in group A at t1-t3(P<0.05).The incidence rate of postoperative agitation was significantly lower in group B than that in group A at 30 minutes,4 hours and 8 hours after surgery(P<0.05).Conclusion The application of laryngeal mask intravenous anesthesia with remimazolam combined with remifentanil during ureteroscopic lithotripsy can achieve good sedation depth and anesthetic effect,and it is helpful to stabilize the hemodynamics and reduce the occurrence of postoperative agitation.It has high safety and is worthy of clinical promotion and application.
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