瑞马唑仑-氟马西尼方案对内窥镜逆行胰胆管造影术患者苏醒情况的影响
Effect of remimazolam-flumazenil regimen on emergence of patients undergoing endoscopic retro-grade cholangiopancreatography
肖艳英 1朱蓉 1戴茹萍 1张燕玲 1傅迪2
作者信息
- 1. 中南大学湘雅二医院麻醉科,长沙 410011
- 2. 中南大学湘雅医院麻醉科,长沙 410078
- 折叠
摘要
目的 评价瑞马唑仑-氟马西尼方案对内窥镜逆行胰胆管造影(ERCP)术患者苏醒情况的影响.方法 选择拟在全身麻醉下行ERCP术患者84例,性别不限,年龄18～78岁,BMI 18～30 kg/m2,ASA分级I-Ⅲ级.采用随机数字表法分为2组(n=42):瑞马唑仑-氟马西尼组(RF组)和丙泊酚组(P组).麻醉诱导:RF组静脉注射瑞马唑仑0.2 mg/kg和瑞芬太尼2 μg/kg;P组静脉注射丙泊酚1.5 mg/kg和瑞芬太尼2 μg/kg.麻醉维持:RF组静脉泵注瑞马唑仑0.5～2.0 mg·kg-1·h-1和瑞芬太尼0.1～0.2μg·kg-1·min-1,P组静脉泵注丙泊酚2～8 mg·kg-1·h-1和瑞芬太尼0.1～0.2μg·kg-1·min-1,维持BIS值40～60.术毕时RF组静脉注射氟马西尼0.2 mg,P组静脉注射等体积生理盐水.记录苏醒时间、喉罩拔除时间、术后复苏室停留时间、苏醒期不良反应发生情况、患者满意度评分、内镜医师满意度评分和术后24 h时15项恢复质量量表评分.结果 与P组比较,RF组苏醒时间、喉罩拔除时间和PACU停留时间缩短,欣快感发生率降低(P＜0.05).2组躁动、头晕、恶心呕吐和再镇静发生率、患者满意度评分、内镜医师满意度评分和术后24 h时15项恢复质量量表评分比较差异无统计学意义(P＞0.05).结论 与丙泊酚相比,瑞马唑仑-氟马西尼方案用于ERCP术患者可缩短苏醒时间,提高苏醒质量.
Abstract
Objective To evaluate the effect of the remimazolam-flumazenil regimen on the emer-gence of patients undergoing endoscopic retrograde cholangiopancreatography(ERCP).Methods Eighty-four American Society of Anesthesiologists Physical Status classification Ⅰ -Ⅲ patients,regardless of gen-der,aged 18-78 yr,with body mass index of 18-30 kg/m2,undergoing elective ERCP under general anes-thesia,were allocated into 2 groups(n=42 each)using a random number table method:remimazolam-flumazenil group(RF group)and propofol group(P group).Anesthesia was induced as follows:Remimazo-lam 0.2 mg/kg and remifentanil 2 μg/kg were intravenously injected in RF group,and propofol 1.5 mg/kg and remifentanil 2 μg/kg were intravenously injected in P group.Anesthesia was maintained as follows:Remimazolam was intravenously infused at a rate of 0.5-2.0 mg·kg-1·h-1 and remifentanil at a rate of 0.1-0.2 μg·kg-1·min-1 in RF group,and propofol was intravenously infused at a rate of 2-8 mg·kg-1·h-1 and remifentanil at a rate of 0.1-0.2 μg·kg-1·min-1 in P group,maintaining a bispectral index value of 40-60.At the end of procedure,RF group received an intravenous injection of flumazenil at 0.2 mg,while P group received an equal volume of normal saline.The emergence time,laryngeal mask re-moval time,duration of post-anesthesia care unit stay,development of adverse events during the emergence period,patients'satisfaction scores,endoscopists'satisfaction scores,and 15-item Quality of Recovery scale scores at 24 h after operation were recorded.Results Compared to P group,the emergence time,laryngeal mask removal time and duration of post-anesthesia care unit stay were significantly shortened,and the inci-dence of euphoria was decreased in RF group(P＜0.05).There were no statistically significant differences between the two groups in the incidence of agitation,dizziness,nausea/vomiting,and re-sedation,patients'satisfaction scores,endoscopists'satisfaction scores,and 15-item Quality of Recovery scale scores at 24 h after operation(P＞0.05).Conclusions Compared to propofol,the remimazolam-flumazenil regimen can shorten the emergence time and improve the quality of recovery when used for ERCP procedures.
关键词
苯二氮类/氟马西尼/二异丙酚/门诊外科手术/胰胆管造影术,内窥镜逆行/麻醉恢复期Key words
Benzodiazepines/Flumazenil/Propofol/Ambulatory surgical procedures/Cholangiopancreatography,endoscopic retrograde/Anesthesia recovery period引用本文复制引用
基金项目
湖南省自然科学基金(2018JJ3769)
湖南省卫生健康委员会科研计划课题(202104112304)
出版年
2024
NETL
NSTL
万方数据