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瑞马唑仑复合舒芬太尼在超声引导神经阻滞期间的镇静镇痛效果

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目的 观察瑞马唑仑复合舒芬太尼在骨科手术超声引导神经阻滞期间的镇静镇痛效果。方法 选择 2023年1~6 月骨科手术80 例,采用随机数字法分为2 组,每组40 例。在麻醉准备室,R组静脉推注10 ml瑞马唑仑(0。15 mg/kg)+舒芬太尼0。1 μg/kg,S组静脉推注10 ml生理盐水+舒芬太尼0。1 μg/kg,2 min后2 组均行超声引导神经阻滞。观察2 组摆体位、神经阻滞进针时和注药时的疼痛视觉模拟评分(Visual Analogue Scale,VAS);阻滞过程中有无不适感或体动;入麻醉准备室、给镇静药后5 min、神经阻滞时、神经阻滞后10 min的平均动脉压、心率、脉搏氧饱和度;不良反应。结果 R组在摆体位、神经阻滞进针时、注药时的VAS评分均为0 分,均明显低于S组(均P =0。000),且阻滞时酸胀感、触电感及疼痛感的发生率均低于S组(P<0。05);但R组一过性舌后坠发生率高于S组(6 例vs。0 例,P =0。026)。S组神经阻滞前后平均动脉压一直维持较高水平(>95 mm Hg),阻滞时最高,而R组给镇静药后MAP降低并一直维持在80~90 mm Hg。结论 瑞马唑仑复合舒芬太尼用于麻醉准备室神经阻滞的镇静镇痛,可提供安全、无痛、无恐惧的"舒适化医疗"服务,且不增加神经损伤及局麻药中毒风险。
Sedative and Analgesic Effects of Remazolam Combined With Sufentanil During Ultrasound-guided Nerve Block
Objective To observe the sedative and analgesic effect of remazolam combined with sufentanil during ultrasound-guided nerve block in patients undergoing orthopedic surgery.Methods A total of 80 patients who underwent orthopedic surgery in our hospital from January to June 2023 were selected.They were randomly assigned to two groups with 40 cases in each group.In anesthesia preparation room,one group was injected intravenously 10 ml remazolam(0.15 mg/kg)+ sufentanil 0.1 μg/kg(R group)and the other group was injected intravenously 10 ml normal saline +sufentanil 0.1 μg/kg(S group).Ultrasound-guided nerve block was performed 2 min later.The Visual Analogue Scale(VAS)of the two groups were observed during the process of postural position,nerve block puncture and drug injection.Whether there was any discomfort or body movement during the nerve block process were recorded.The mean arterial pressure(MAP),heart rate,and pulse oxygen saturation were measured at baseline,5 min after intravenous injection,nerve block injection,and 10 min after nerve block.Adverse reactions were noted.Results The VAS scores of the R group were 0 point at the time of postural position,nerve block puncture and drug injection,which were significantly lower than those of the S group(all P =0.000).The incidence of sore swelling,electrical sensation,and pain at the time of nerve block of the R group were lower than those of the S group(P<0.05).The incidence of transient glossoptosis of the R group was higher than that of the S group(6 cases vs.0 case,P =0.026).The MAP before and after nerve block in the S group remained at a high level(>95 mm Hg),and the highest MAP appeared at the time point of nerve block;while the MAP of the R group decreased and remained at 80-90 mm Hg after sedation.Conclusion Remazolam combined with sufentanil can provide safe,painless,fear free"comfort medical service"for nerve block sedation and analgesia in anesthesia preparation room,and does not increase the risk of nerve injury and local anesthetic poisoning.

RemazolamNerve blockComfort medical service

刘小红、姚军、卢清旺、颜景佳

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晋江市医院 上海市第六人民医院福建医院麻醉科,泉州 362200

上海交通大学医学院附属第六人民医院麻醉科,上海 200233

瑞马唑仑 神经阻滞 舒适化医疗

2024

中国微创外科杂志
北京大学

中国微创外科杂志

CSTPCD北大核心
影响因子:2.21
ISSN:1009-6604
年,卷(期):2024.24(3)
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