Koch Rebecca, Witkam Richard, van Eijk Lucas T, Bruhn Jörgen
Anesthesiology, Radboud University Medical Center, Nijmegen, NLD.
Anesthesiology, Radboud University Medical Center,, Nijmegen, NLD.
Cureus. 2024 Aug 12;16(8):e66737. doi: 10.7759/cureus.66737. eCollection 2024 Aug.
There is an ongoing quest for an uniform anesthesia regimen that adequately covers all nociceptive stimuli preventing hypertension and tachycardia while minimizing hypotension and the need for antihypotensive drugs. Recently, the ultra-short-acting benzodiazepine remimazolam was approved for the induction and maintenance of general anesthesia. Combining remimazolam with sevoflurane and propofol may combine the antiemetic properties of propofol, the depressing (immobilizing) effect on spinal motor neurons of sevoflurane, and the hemodynamic stability afforded by remimazolam, making it an attractive addition to the armamentarium of anesthetic agents. We describe five patients in whom general anesthesia was maintained with this triple combination, along with multimodal analgesia. All patients maintained hemodynamic stability at sufficient hypnotic depth, with no observable movement during surgery or episodes of cardiac arrhythmias.
目前正在寻求一种统一的麻醉方案，该方案能充分覆盖所有伤害性刺激，预防高血压和心动过速，同时将低血压及抗低血压药物的需求降至最低。最近，超短效苯二氮䓬类药物瑞马唑仑被批准用于全身麻醉的诱导和维持。将瑞马唑仑与七氟烷和丙泊酚联合使用，可能会兼具丙泊酚的止吐特性、七氟烷对脊髓运动神经元的抑制（制动）作用以及瑞马唑仑提供的血流动力学稳定性，使其成为麻醉药物库中颇具吸引力的补充药物。我们描述了五例使用这种三联组合维持全身麻醉并联合多模式镇痛的患者。所有患者在足够的催眠深度下维持了血流动力学稳定，手术期间未观察到明显的肢体活动或心律失常发作。
