Mao Shimeng, Gao Ruijia, Huang Yu, He Hongyan, Yao Jinliang, Feng Jiying
Department of Anesthesiology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, No. 6 Zhenhua East Road, Lianyungang, 222002, Jiangsu, China.
Department of Anesthesiology, The First Affiliated Hospital of Kangda College of Nanjing Medical University, No.6 Zhenhua East Road, Lianyungang, 222002, Jiangsu, China.
Eur J Med Res. 2025 Feb 19;30(1):118. doi: 10.1186/s40001-025-02381-1.
The objective of this study is to examine the impact of administering remimazolam and estazolam in alleviating preoperative anxiety on the recovery of gastrointestinal function in patients undergoing laparoscopic cholecystectomy surgery.
A total of 140 patients who were scheduled for elective laparoscopic cholecystectomy surgery were randomly divided into four groups using random number table: remimazolam group (group R, n = 35), estazolam group (group E, n = 35), remimazolam combined with estazolam group (group RE, n = 35), and control group (group C, n = 35). Group R received an intravenous injection of remimazolam before the administration of anesthesia, group E was orally administered estazolam on the night before surgery and intravenously injected with normal saline before induction of anesthesia, group RE received both estazolam orally on the night before surgery and intravenous injection of remimazolam before induction of anesthesia, and group C was given normal saline before induction of anesthesia. The visual analogue scale for anxiety (VAS-A) scores were documented during the preoperative visit, following entry into the operating room, and 10 min after intravenous remimazolam or normal saline. Time to the first postoperative exhaust and defecation, occurrence of nausea and vomiting within 24 h after surgery, sleep quality scores on the night before surgery and two nights after surgery as per Numerical Rating Scale (NRS), postoperative patient satisfaction, and occurrence of adverse reactions were also recorded.
In contrast to group C, time to the first postoperative exhaust and defecation of groups R, E, and RE were significantly reduced (P < 0.05); the VAS-A scores of groups E and RE exhibited a significant decrease upon entering the operating room, and the VAS-A scores of groups R, E, and RE decreased significantly 10 min after intravenous remimazolam or normal saline (P < 0.05); sleep quality scores of groups R, E, and RE were significantly higher on the first night after surgery (P < 0.05). There was no significant difference in the occurrence of nausea and vomiting among the four groups within 24 h after surgery. No adverse reactions such as wound bleeding, infection, and severe abdominal distension occurred in the four groups.
The utilization of remimazolam and estazolam, either singularly or in combination, before laparoscopic cholecystectomy surgery, has shown considerable efficacy in alleviating preoperative anxiety, and thus expediting the recovery of postoperative gastrointestinal function in patients. Moreover, the combination of both agents can improve the patient's postoperative sleep quality, thereby elevating patient satisfaction.
本研究的目的是探讨使用瑞马唑仑和艾司唑仑减轻术前焦虑对腹腔镜胆囊切除术患者胃肠功能恢复的影响。
将140例择期行腹腔镜胆囊切除术的患者采用随机数字表法随机分为四组：瑞马唑仑组（R组，n = 35）、艾司唑仑组（E组，n = 35）、瑞马唑仑联合艾司唑仑组（RE组，n = 35）和对照组（C组，n = 35）。R组在麻醉给药前静脉注射瑞马唑仑，E组在手术前一晚口服艾司唑仑，麻醉诱导前静脉注射生理盐水，RE组在手术前一晚口服艾司唑仑且在麻醉诱导前静脉注射瑞马唑仑，C组在麻醉诱导前给予生理盐水。记录术前访视时、进入手术室时以及静脉注射瑞马唑仑或生理盐水后10分钟的焦虑视觉模拟量表（VAS-A）评分。还记录术后首次排气和排便时间、术后24小时内恶心呕吐的发生情况、根据数字评分量表（NRS）评估的手术前一晚和术后两晚的睡眠质量评分、术后患者满意度以及不良反应的发生情况。
与C组相比，R组、E组和RE组术后首次排气和排便时间显著缩短（P < 0.05）；E组和RE组进入手术室时VAS-A评分显著降低，R组、E组和RE组静脉注射瑞马唑仑或生理盐水后10分钟VAS-A评分显著降低（P < 0.05）；R组、E组和RE组术后第一晚睡眠质量评分显著更高（P < 0.05）。四组术后24小时内恶心呕吐的发生率无显著差异。四组均未发生伤口出血、感染和严重腹胀等不良反应。
在腹腔镜胆囊切除术手术前单独或联合使用瑞马唑仑和艾司唑仑，在减轻术前焦虑方面显示出显著疗效，从而加快患者术后胃肠功能的恢复。此外，两种药物联合使用可改善患者术后睡眠质量，从而提高患者满意度。
