Research on the application of remimazolam in the induction period of general anesthe-sia in the plateau area——Taking Xizang University Affiliated Fukang Hospital as an Example
Objective To observe the sedative effect and hemodynamic changes of remimazolam in adult Tibetan pa-tients in the plateau area during the induction period of general anesthesi.Methods A total of 120 patients were se-lected,following a series of critera including undergoing elective surgery under general anesthesia from June to Sep-tember 2023,aged 18～60 years,male or female,with a BMI of 20～25 kg/m2 and ASA grades Ⅰ～Ⅱ.120 patients were evenly divided into three groups(n=40)by a random number table method:propofol group(P group),remimazolam 1 group(R1 group),and remimazolam 2 group(R2 group).Slow intravenous injections were given to the three groups that P group received propofol 2mg/kg,R1 group received remimazolam 0.3mg/kg,and R2 group received remima-zolam 0.4mg/kg with afentanil 20 μg/kg and rocuronium bromide 0.6mg/kg for intravenous anesthesia induction.Monitoring records the data of the SBP,MAP,DBP,HR,BIS,and SpO2 before anesthesia induction(T0),after seda-tion onset(T1),before endotracheal intubation(T2),and 1 minute(T3),3 minutes(T4),and 5 minutes(T5)after endotra-cheal intubation,as well as the modified MOAA/S≤1min and BIS sedation onset time.The changes in hemodynamic indicators at different time points and the occurrence of adverse events such as hypotension,sinus bradycardia,injec-tion pain,sedation relief,and intraoperative awareness were compared among the three groups.Results There were no statistically significant differences among the three groups.Compared with T0,SBP,MAP,DBP,and BIS de-creased in the three groups from T1 to T5(P＜0.05).Compared with P group,there were statistically significant differ-ences in SBP at T1～T5 in R1 group and T4～T5 in R2 group(P＜0.05),and HR at T1～T5 in R1 and R2 groups(P＜0.05).There was a statistically significant difference in BIS at T1～T3 between P group and R1 group(P＜0.05).The inci-dence rates of hypotension in the P,R1,and R2 groups were 65.0%,30.0%,and 37.5%(χ2=11.017,P=0.004);the inci-dence rates of sinus bradycardia were 55.0%,32.5%,and 27.5%respectively(χ2=7.262,P=0.026);the incidence rates of intravenous injection pain were 70.0%,25.0%,and 20.0%respectively(χ2=25.66,P=0.000);the time(seconds)re-quired for BIS≤60 were 73.2±10.4,82.7±14.5,and 73.4±14.0(t=3.965,P=0.030)respectively;and the time(sec-onds)required for MOAA/S≤1 were 62.8±9.7,69.4±9.0,and 57.3±11.4(t=2.408,P=0.098)respectively.No intraop-erative awareness occurred among the three groups.Conclusion The use of remimazolam for the intravenous induc-tion of general anesthesia in adult Tibetan patients in the plateau area is safe,effective,and hemodynamically stable.
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