Safety and Efficacy of Non-Intubated General Anesthesia with Remimazolam Combined with Remifentanil in AngioJet Mechanical Thrombectomy for Lower Extremity Deep Vein Thrombosis
OBJECTIVE:To probe into the safety and efficacy of non-intubated general anesthesia with remimazolam combined with remifentanil in AngioJet mechanical thrombectomy for lower extremity deep vein thrombosis.METHODS:Totally 120 patients who underwent AngioJet mechanical thrombectomy for lower extremity deep vein thrombosis in Linyi People's Hospital from Oct.2021 to Oct.2023 were extracted to be divided into the non-intubated general anesthesia group(n=60)and awake sedation group(n=60)through the random number table method.The non-intubated general anesthesia group received remimazolam combined with remifentanil for non-intubated general anesthesia,while the awake sedation group was given awake sedation anesthesia.Vital signs of two groups of patients,including systolic blood pressure(SBP),diastolic blood pressure(DBP),cardiac output(CO),systemic vascular resistance(SVR),stroke volume and heart rate were compared at at the time of admission(T1),target vessel puncture(T2),drug spraying(T3),15 minutes after drug spraying(T4),thrombus aspiration(T5),and 5 minutes after surgery(T6),1 hour after surgery(T7),4 hours after surgery(T8),and 12 hours after surgery(T9).The use of antihypertensive drugs during and after surgery,occurrence of hematuria and adverse events,target vessel puncture time,patients'satisfaction score,and clinicians'satisfaction score were recorded and compared between two groups.RESULTS:(1)From T1 to T9,there were statistically significant differences within the SBP and DBP groups between the non-intubated general anesthesia group and awake sedation group(P<0.001).Both groups showed an increase in SBP and DBP at T3 and returned to normal at T9.The non-intubated general anesthesia group showed a significant decrease in SBP and DBP from T2 to T5 compared with the awake sedation group,with statistically significant difference(P<0.001).(2)From T1 to T6,there were statistically significant differences with SVR and CO groups between the non-intubated general anesthesia group and awake sedation group(P<0.001).SVR increased in both groups from T3 to T6,while CO decreased in both groups from T2 to T5.At various time points from T2 to T6,SVR of the non-intubated general anesthesia group was significantly lower than that of the awake sedation group,with statistically significant difference(P<0.05).At various time points from T3 to T6,CO in the non-intubated general anesthesia group were significantly higher than those in the awake sedation group,with statistically significant difference(P<0.05).(3)The clinicians'satisfaction score and patients'satisfaction score in the non-intubation general anesthesia group were significantly higher than those in the wake sedation group,with statistically significant differences(P<0.001).(4)The use rate of antihypertensive drugs during surgery,the incidence of body movements,the incidence of severe hypertension and hypertensive subacute disease during surgery in the non-intubated general anesthesia group were significantly lower than those in the wake sedation group,with statistically significant differences(P<0.001).CONCLUSIONS:Remazolam combined with remifentanil for non-intubation general anesthesia has good safety and efficacy in AngioJet mechanical thrombectomy for lower extremity deep vein thrombosis.
RemimazolamRemifentanilNon-intubated general anesthesiaLower extremity deep vein thrombosisPerioperative hypertension
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