Ko Eunji, Choi Sung Uk, Lee Jaehee, Choi Eun-Saem, Park Yoon Sun
Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Seoul, South Korea.
Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul, South Korea.
Heliyon. 2024 Mar 29;10(7):e28485. doi: 10.1016/j.heliyon.2024.e28485. eCollection 2024 Apr 15.
Remimazolam has recently been introduced as a maintenance agent for general anesthesia. However, the effect of remimazolam on peripartum prognosis has not been reported. Therefore, this study aimed to compare the effects of remimazolam and propofol for uterotonic drugs following cesarean section.
The electronic medical records of 51 adult women who underwent elective cesarean sections by single obstetrician under general anesthesia were collected. Participants were categorized into two groups: the propofol group and the remimazolam group. General anesthesia was maintained by continuous infusion of propofol or remimazolam after delivery. The number of uterotonic drugs administered during the cesarean section, the estimated blood loss (EBL), and length of hospital stay (LOS) after delivery were assessed.
Of the 51 patients included in the study, 35 were in the propofol group and 16 in the remimazolam group. In the remimazolam group, five patients (31.3%, 5/16) received more uterotonics than the standard regimen. Conversely, in the propofol group, 19 patients (54.3%, 19/35) were injected with more uterotonics than the standard regimen. Logistic regression analysis showed that abnormal positioning of the placenta ( = 0.079) and not using remimazolam ( = 0.100) were the most relevant factors associated with the increased use of uterotonics. There was no significant difference in EBL between the two groups. The use of remimazolam was clinically relevant with a shorter LOS ( = 0.059).
The use of remimazolam as a maintenance agent did not result in significantly higher use of intrapartum uterotonics compared to the use of propofol. These results cannot exclude all adverse effects of remimazolam during cesarean delivery. Further randomized controlled trials must be conducted to obtain high-quality evidence.
瑞马唑仑最近被引入作为全身麻醉的维持药物。然而，瑞马唑仑对围产期预后的影响尚未见报道。因此，本研究旨在比较瑞马唑仑和丙泊酚在剖宫产术后对宫缩剂使用的影响。
收集了51例由单一产科医生在全身麻醉下进行择期剖宫产的成年女性的电子病历。参与者被分为两组：丙泊酚组和瑞马唑仑组。分娩后通过持续输注丙泊酚或瑞马唑仑维持全身麻醉。评估剖宫产期间使用宫缩剂的数量、估计失血量（EBL）和分娩后的住院时间（LOS）。
在纳入研究的51例患者中，丙泊酚组35例，瑞马唑仑组16例。在瑞马唑仑组中，5例患者（31.3%，5/16）使用的宫缩剂比标准方案多。相反，在丙泊酚组中，19例患者（54.3%，19/35）注射的宫缩剂比标准方案多。逻辑回归分析表明，胎盘位置异常（=0.079）和未使用瑞马唑仑（=0.100）是与宫缩剂使用增加最相关的因素。两组之间的EBL没有显著差异。瑞马唑仑的使用与较短的住院时间在临床上相关（=0.059）。
与使用丙泊酚相比，使用瑞马唑仑作为维持药物并没有导致产时宫缩剂的使用显著增加。这些结果不能排除瑞马唑仑在剖宫产期间的所有不良反应。必须进行进一步的随机对照试验以获得高质量的证据。
