摘要
目的 评价瑞马唑仑用于结直肠肿瘤患者麻醉诱导的效果.方法 本研究为前瞻性研究.选取本院2023年6月至11月择期全麻下行结直肠肿瘤手术患者82例,年龄18～80岁,BMI 18.5～28.0 kg/m2,ASA分级Ⅰ-Ⅲ级.采用随机数字表法分为2组(n=41):丙泊酚组(P组)和瑞马唑仑组(R组).P组静脉注射丙泊酚1.5 mg/kg,R组静脉注射瑞马唑仑0.3 mg/kg,BIS值≤60时静脉注射舒芬太尼0.5 μg/kg和顺阿曲库铵0.2 mg/kg.于麻醉诱导前(T0)、诱导后3 min(T1)、气管插管即刻(T2)和插管后5 min(T3)时记录HR和MAP.记录诱导期低血压、高血压、心动过速、心动过缓的发生情况、血管活性药使用情况以及注射痛发生情况,记录意识消失时间、从给药开始至BIS值≤60的时间、给药开始至气管插管时间、气管插管即刻BIS值＞60的发生情况和补救镇静情况.结果 最终纳入80例患者,其中P组40例,R组40例.与P组比较,R组T1和T2时MAP和HR升高,低血压和心动过缓发生率降低,从给药开始至BIS值≤60的时间延长(P＜0.05),其余指标差异无统计学意义(P＞0.05).结论 瑞马唑仑0.3 mg/kg可安全有效地用于结直肠肿瘤患者的麻醉诱导,相较于丙泊酚1.5 mg/kg,维持血流动力学稳定的效果更好.
Abstract
Objective To evaluate the efficacy of remimazolam for induction of anesthesia in pa-tients with colorectal cancer.Methods This was a prospective study.Eighty-two patients scheduled for elective colon and rectal tumor surgery under general anesthesia from June to November 2023 at our hospi-tal,aged 18-80 yr,with body mass index of 18.5-28.0 kg/m2,of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ,were divided into 2 groups(n=41 each)using a random number table method:propofol group(group P)and remimazolam group(group R).Propofol 1.5 mg/kg was intravenous-ly injected in group R and remimazolam 0.3 mg/kg was intravenously injected in group P.When the bispec-tral index(BIS)value≤60,sufentanil 0.5 μg/kg and cisatracurium 0.2 mg/kg were intravenously injected in both groups.Heart rate and mean arterial pressure were recorded before induction of anesthesia(T0),3 min after induction(T1),immediately after intubation(T2),and 5 min after tracheal intubation(T3).The occurrence of hypotension,hypertension,tachycardia and bradycardia during induction,use of vasoactive drugs,and injection pain were recorded.The time to loss of consciousness,time from the beginning of ad-ministration to BIS value ≤ 60,time from the beginning of administration to tracheal intubation,occurrence of BIS value＞60 immediately after intubation and rescue sedation were recorded.Results Eighty patients were finally included,with 40 in group P and 40 in group R.Compared with group P,the heart rate and mean arte-rial pressure were significantly increased at T,and T2,the incidence of hypotension and bradycardia was de-creased,and the time from the beginning of administration to BIS value ≤60 was prolonged(P＜0.05),and no statistically significant changes were found in the other parameters in group R(P＞0.05).Conclusions Remimazolam 0.3 mg/kg can be safely and effectively used for anesthesia induction and provides better efficacy in maintaining hemodynamic stability when compared with propofol 1.5 mg/kg in patients with colorectal cancer.
基金项目
河北省卫生健康委重点科技研究计划(20211163)
河北省卫生健康委重点科技研究计划(20220163)
河北省自然科学基金(H2020206590)
NETL
NSTL
万方数据