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瑞马唑仑与丙泊酚用于宫腔镜检查时无肌松药下插入喉罩的可行性和安全性。

Feasibility and Safety of Remazolam versus Propofol When Inserting Laryngeal Masks Without Muscle Relaxants During Hysteroscopy.

机构信息

Department of Anesthesiology, East Hospital, Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China.

Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China.

出版信息

Drug Des Devel Ther. 2023 May 1;17:1313-1322. doi: 10.2147/DDDT.S408584. eCollection 2023.

Abstract

PURPOSE

This study aimed to evaluate the efficacy and safety of remazolam compared with propofol in patients who underwent laryngeal mask airway (LMA) insertion without the use of muscle relaxant agents during hysteroscopic surgery.

PATIENTS AND METHODS

A total of 72 patients undergoing hysteroscopy with LMA insertion were assigned to two groups. The patients in the remazolam group received 0.3 μg/kg sufentanil, 0.3 mg/kg remazolam and 1.2 mg/kg remifentanil, whereas the patients in the propofol group received 0.3 μg/kg sufentanil, 2.0 mg/kg propofol and 1.2 mg/kg remifentanil for insertion of the LMA. The primary endpoint was the summed score of the insertion conditions. The secondary endpoints included hemodynamics, the duration of induction, the duration of insertion, tidal volume, plateau pressure and adverse events.

RESULTS

No difference was identified between the propofol group and remazolam group in the median summed score [18.0 (18.0, 18.0), 18.0 (17.0, 18.0), respectively, > 0.05]. The induction duration was significantly longer ( < 0.05) in the remazolam group than propofol group. The cost of dopamine ( < 0.05) was significantly lower in the remazolam group compared with the patients in the propofol group, while the plateau pressure ( < 0.05) and the incidence of transient mild laryngospasm ( < 0.05) were significantly higher in the remazolam group. No differences were identified between the two groups in terms of heart rate, tidal volume, injection pain or hiccups ( > 0.05).

CONCLUSION

Remazolam provided similar insertion conditions and better hemodynamic stability than propofol during LMA insertion without the use of muscle relaxant agents. However, a higher incidence of transient mild laryngospasm was found in the remazolam group, which should be considered.

摘要

目的

本研究旨在评估在无肌松剂条件下,喉罩置入时使用瑞马唑仑与丙泊酚的疗效和安全性。

患者与方法

共 72 例行宫腔镜手术且需置入喉罩的患者被分为两组。瑞马唑仑组患者接受 0.3μg/kg 舒芬太尼、0.3mg/kg 瑞马唑仑和 1.2mg/kg 瑞芬太尼,而丙泊酚组患者接受 0.3μg/kg 舒芬太尼、2.0mg/kg 丙泊酚和 1.2mg/kg 瑞芬太尼进行喉罩置入。主要终点为置入条件的总评分。次要终点包括血流动力学、诱导时间、置入时间、潮气量、平台压和不良事件。

结果

在中位数总和评分方面,丙泊酚组与瑞马唑仑组之间无差异[18.0(18.0,18.0),18.0(17.0,18.0),>0.05]。瑞马唑仑组的诱导时间明显较长(<0.05)。与丙泊酚组相比,瑞马唑仑组多巴胺的花费显著降低(<0.05),而平台压(<0.05)和一过性轻度喉痉挛的发生率(<0.05)显著升高。两组间心率、潮气量、注射痛或呃逆差异无统计学意义(>0.05)。

结论

在无肌松剂条件下,与丙泊酚相比,瑞马唑仑提供了相似的置入条件和更好的血流动力学稳定性。然而,瑞马唑仑组发现一过性轻度喉痉挛的发生率更高,应予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de0d/10162397/36bc8d5e0ea3/DDDT-17-1313-g0001.jpg

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