Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan 54538, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
Medicina (Kaunas). 2023 Mar 15;59(3):578. doi: 10.3390/medicina59030578.
Anesthesia maintenance agents affect the incidence of postoperative shivering (PS) after general anesthesia. This study compared the effects of remimazolam with sevoflurane on PS in patients undergoing laparoscopic gynecologic surgery under general anesthesia. : Seventy-four patients were allocated into one of two groups. In anesthesia maintenance, group S received sevoflurane and remifentanil, and group R received remimazolam and remifentanil. The incidence and severity of postoperative shivering, mean arterial pressure (MAP), heart rate (HR), core body temperature, and the association of PS with hypothermia, MAP, or HR in the post-anesthesia care unit (PACU) were measured. Group R had significantly lower rates of perioperative hypothermia (58.8 vs. 27.8%, = 0.009) and postoperative shivering (41.2 vs. 19.4%, = 0.047). The severity of PS was also lower in group R than in group S ( = 0.034). Core body temperature was significantly higher in group R than in group S from 10 min after induction ( = 0.047) to the PACU ( = 0.009). MAP and HR were significantly higher in group R than in group S from 20 min after induction ( = 0.047) to the PACU ( = 0.009). In group S, the correlation between the severity of PS and the incidence of hypothermia (φc = 0.414, = 0.121) was moderate but not significant. In group R, the correlation between PS severity and hypothermia (φc = 0.418, = 0.043) was moderate and significant. Remimazolam showed better results than sevoflurane in anesthesia maintenance regarding hypothermia and PS.
麻醉维持药物会影响全身麻醉后寒战（PS）的发生率。本研究比较了瑞马唑仑和七氟醚对全身麻醉下腹腔镜妇科手术患者 PS 的影响。
将 74 例患者分为两组。在麻醉维持中，S 组接受七氟醚和瑞芬太尼，R 组接受瑞马唑仑和瑞芬太尼。测量术后寒战的发生率和严重程度、平均动脉压（MAP）、心率（HR）、核心体温，以及 PS 与麻醉后监护病房（PACU）中体温过低、MAP 或 HR 的相关性。R 组围术期低体温（58.8% vs. 27.8%， = 0.009）和术后寒战（41.2% vs. 19.4%， = 0.047）的发生率明显较低。R 组 PS 严重程度也低于 S 组（ = 0.034）。从诱导后 10 分钟（ = 0.047）到 PACU，R 组的核心体温明显高于 S 组（ = 0.009）。从诱导后 20 分钟（ = 0.047）到 PACU，R 组的 MAP 和 HR 明显高于 S 组（ = 0.009）。在 S 组，PS 严重程度与低体温发生率之间的相关性（φc = 0.414， = 0.121）为中度，但无统计学意义。在 R 组，PS 严重程度与低体温之间的相关性（φc = 0.418， = 0.043）为中度且有统计学意义。瑞马唑仑在麻醉维持方面比七氟醚在低体温和 PS 方面效果更好。
