瑞米唑仑用于经股动脉途径经导管主动脉瓣植入术中麻醉监测的可行性和有效性。
Feasibility and efficacy of remimazolam for anesthesia monitoring in transcatheter aortic valve implantation via femoral artery access.
作者信息
Liang Xin, Deng Xin, Lao Qiying, Chen Longqian, Liang Yanli, Yang Liu
机构信息
Department of Anesthesiology, Central People's Hospital of Zhanjiang Zhanjiang 524031, Guangdong, China.
Guangdong Medical University Dongguan 523808, Guangdong, China.
出版信息
Am J Transl Res. 2025 May 15;17(5):3530-3537. doi: 10.62347/QUMD4078. eCollection 2025.
OBJECTIVE
To evaluate the effect of remimazolam during anesthesia monitoring in transcatheter aortic valve implantation (TAVI) via femoral artery catheter (FAC).
METHODS
We reviewed the medical records of 50 patients who underwent TAVI via FAC from July 2022 to September 2023. Patients were divided into two groups: a control group (receiving propofol, n=25) and a remimazolam group (receiving remimazolam, n=25). Pulse oxygen saturation (SpO), heart rate (HR), mean arterial pressure (MAP) and Bispectral Index (BIS) were recorded at various time points: 5 min before anesthesia (T0), 0 (T1), 5 (T2), 10 (T3), 15 (T4), and 20 min (T5) after infusion. Operation time, blood loss, awakening time, quality of recovery (QoR-15) scores before operation and 1 and 3 days after operation were recorded and compared between the two groups. Additionally, the incidence of delirium at 1-day post-operation was compared between the two groups. The incidence of adverse reactions and patient satisfaction were compared between the groups.
RESULTS
At T2, T3, T4 and T5, the remimazolam group exhibited significantly higher SpO, HR and MAP than the control group (P<0.05); BIS values and modified observer's assessment of alertness/sedation (MOAA/S) scores showed no significant differences (P>0.05). The remimazolam group also had significantly earlier awakening times (P<0.05), without differences in operation time or blood loss (P<0.05). QoR-15 scores at 1 and 3 days post-operation were higher in the remimazolam group (P<0.05). The incidence of postoperative delirium was slightly lower in the remimazolam group (P>0.05). The control group had a higher total incidence of adverse reactions and lower satisfaction compared to the remimazolam group (P<0.05).
CONCLUSION
Remimazolam is an effective sedative for TAVI anesthesia, associated with lower postoperative adverse reactions, thus facilitating better recovery.
目的
评估瑞马唑仑在经股动脉导管（FAC）行主动脉瓣置换术（TAVI）麻醉监测中的效果。
方法
回顾2022年7月至2023年9月期间50例行FAC-TAVI患者的病历。患者分为两组：对照组（接受丙泊酚，n=25）和瑞马唑仑组（接受瑞马唑仑，n=25）。记录不同时间点的脉搏血氧饱和度（SpO）、心率（HR）、平均动脉压（MAP）和脑电双频指数（BIS）：麻醉前5分钟（T0）、输注后0（T1）、5（T2）、10（T3）、15（T4）和20分钟（T5）。记录并比较两组的手术时间、失血量、苏醒时间、术前及术后1天和3天的恢复质量（QoR-15）评分。此外，比较两组术后1天谵妄的发生率。比较两组不良反应的发生率和患者满意度。
结果
在T2、T3、T4和T5时，瑞马唑仑组的SpO、HR和MAP显著高于对照组（P<0.05）；BIS值和改良的警觉/镇静观察评分（MOAA/S）无显著差异（P>0.05）。瑞马唑仑组的苏醒时间也显著更早（P<0.05），手术时间和失血量无差异（P<0.05）。瑞马唑仑组术后1天和3天的QoR-15评分更高（P<0.05）。瑞马唑仑组术后谵妄的发生率略低（P>0.05）。与瑞马唑仑组相比，对照组的不良反应总发生率更高，满意度更低（P<0.05）。
结论
瑞马唑仑是TAVI麻醉的有效镇静剂，术后不良反应较低，有助于更好地恢复。
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