Xie Manjie, Zeng Fanrui, Tian Qiao, Deng Huiwei, Tao Shanqing
Department of Anesthesiology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde, China.
Department of Orthopedic Surgery, Changde Second People's Hospital, Changde, China.
Front Med (Lausanne). 2024 Nov 7;11:1409233. doi: 10.3389/fmed.2024.1409233. eCollection 2024.
To evaluate the safety and efficacy of remimazolam in hysteroscopic surgery in elderly patients.
Following hysteroscopic surgery under selected general anesthesia, 60 elderly patients ASA (American Society of Anesthesiologists) class II-III, >65 years old were randomly assigned to one of two groups: the R group (remimazolam) or the C group (propofol), each with 30 patients. Sufentanil 0.1 μg/kg was given 5 min before the operation, remimazolam 0.2 mg/kg intravenously in Group R, then 0.51 mg/(kg.h) by pump, propofol 2 mg/kg intravenously in group B, and then 48 mg/(kg.h) by pump. Maintain BIS (Bispectral index) 40~70, add remimazolam 0.05 mg/kg or propofol 0.5 mg/kg when the patient is in motion, and stop the administration at the end of the operation. Record the patients' HR, MAP, RR, SpO2, PETCO2, and BIS values at entry (T0), before induction administration (T1), 1 min after administration (T2), 5 min after administration (T3), when stopping administration (T4), when awakening (T5), and 1 min after awakening (T6), as well as the onset time after administration, the awakening time, the success rate of sedation, and the number and dose of additional medications. Reactions are adverse (hypotension, hypertension, respiratory depression incidence, injection pain, nausea and vomiting following surgery, etc.).
The two groups' respective anesthetic success rates were comparable overall. In addition to having a higher BIS value and more extra medications than group C, group R experienced less incidence of respiratory depression, injection pain, and intraoperative hypotension.
Remimazolam, which is equivalent to propofol in terms of safety and efficacy for older patients undergoing hysteroscopic surgery, should be further promoted and used.
评估瑞米唑仑用于老年患者宫腔镜手术的安全性和有效性。
在择期全身麻醉下行宫腔镜手术,将60例年龄>65岁、美国麻醉医师协会(ASA)分级为II-III级的老年患者随机分为两组:R组(瑞米唑仑)和C组(丙泊酚),每组30例。手术前5分钟给予舒芬太尼0.1μg/kg,R组静脉注射瑞米唑仑0.2mg/kg,然后以0.51mg/(kg·h)泵注;B组静脉注射丙泊酚2mg/kg,然后以48mg/(kg·h)泵注。维持脑电双频指数(BIS)在40~70,患者术中体动时追加瑞米唑仑0.05mg/kg或丙泊酚0.5mg/kg,手术结束时停止给药。记录患者入室时(T0)、诱导给药前(T1)、给药后1分钟(T2)、给药后5分钟(T3)、停药时(T4)、苏醒时(T5)、苏醒后1分钟(T6)的心率(HR)、平均动脉压(MAP)、呼吸频率(RR)、脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)及BIS值,以及给药起效时间、苏醒时间、镇静成功率、追加药物的数量及剂量。观察不良反应(低血压、高血压、呼吸抑制发生率、注射痛、术后恶心呕吐等)。
两组麻醉总成功率相当。R组除BIS值高于C组且追加药物较多外,呼吸抑制、注射痛及术中低血压发生率低于C组。
瑞米唑仑用于老年患者宫腔镜手术的安全性和有效性与丙泊酚相当,值得进一步推广应用。