瑞芬太尼增强宫腔镜手术患者麻醉诱导期瑞米唑仑的镇静效果：一项随机对照试验
Remifentanil enhances the sedative effect of remimazolam during anesthesia induction in patients undergoing hysteroscopy: a randomized controlled trial.
作者信息
Xie Zhengui, Liao Yeqing, Chen Qiuling, Zhang Cuiwen, Luo Jiaxin, Cao Huiyu, Lin Yuliu, Lan Hongmeng, Huang Xiaofang, Guan Xuehai
机构信息
Department of Anesthesiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, PR China.
出版信息
Ann Med. 2025 Dec;57(1):2534850. doi: 10.1080/07853890.2025.2534850. Epub 2025 Jul 23.
BACKGROUND
Remimazolam is a novel, short-acting benzodiazepine. This study aimed to investigate whether remifentanil enhances the sedative effect of remimazolam during anesthesia induction in patients undergoing hysteroscopy.
METHODS
We included 258 adult patients who underwent hysteroscopy. Patients were randomly allocated to three groups ( = 86) in a 1:1:1 ratio. Patients in the saline group received no remifentanil but normal saline during anesthesia induction. Patients in the remifentanil-1 group received low-dose remifentanil (plasma concentration 1 ng/ml), and those in the remifentanil-2 group received higher doses of remifentanil (plasma concentration 2 ng/ml) during anesthesia induction. After reaching the preset plasma concentration of remifentanil, remimazolam was administered (5 mg/kg/h) until loss of consciousness (LOC). During anesthesia maintenance, remimazolam and remifentanil were changed to ensure that the MOAA/S score reached 0. The primary outcome was the time from remimazolam administration to LOC. The secondary outcomes included the doses of remimazolam until LOC, characteristics of the operation and anesthesia, vital signs, and adverse events.
RESULTS
The time from remimazolam administration to LOC was 154 (139, 180), 120 (104, 139), and 117 (105, 135) s in the saline group, remifentanil-1group, and remifentanil-2 groups, respectively ( < 0.05). The doses of remimazolam until LOC were 12(11, 13), 9.6(8.7, 11), and 8.9(7.9, 10) mg in the saline group, remifentanil-1group, and remifentanil-2 groups, respectively ( < 0.05). There was no significant difference in the characteristic of surgery and anesthesia between groups.
CONCLUSION
Remifentanil enhances the sedative effect of remimazolam during anesthesia induction in patients undergoing hysteroscopy.
CLINICAL TRIAL REGISTRATION
The trial was registered at http://www.chictr.org.cn (ChiCTR2200062983).
背景
瑞马唑仑是一种新型短效苯二氮䓬类药物。本研究旨在探讨瑞芬太尼是否能增强宫腔镜检查患者麻醉诱导期间瑞马唑仑的镇静效果。
方法
我们纳入了258例接受宫腔镜检查的成年患者。患者按1:1:1的比例随机分为三组（每组 = 86例）。生理盐水组患者在麻醉诱导期间未接受瑞芬太尼，而是接受生理盐水。瑞芬太尼-1组患者在麻醉诱导期间接受低剂量瑞芬太尼（血浆浓度1 ng/ml），瑞芬太尼-2组患者在麻醉诱导期间接受高剂量瑞芬太尼（血浆浓度2 ng/ml）。在达到预设的瑞芬太尼血浆浓度后，给予瑞马唑仑（5 mg/kg/h）直至意识丧失（LOC）。在麻醉维持期间，调整瑞马唑仑和瑞芬太尼的剂量以确保脑电双频指数（MOAA/S）评分达到0。主要结局是从给予瑞马唑仑到意识丧失的时间。次要结局包括直至意识丧失时瑞马唑仑的剂量以及手术和麻醉的特征、生命体征和不良事件。
结果
生理盐水组、瑞芬太尼-1组和瑞芬太尼-2组从给予瑞马唑仑到意识丧失的时间分别为154（139，180）秒、120（104，139）秒和117（105，135）秒（P < 0.05）。直至意识丧失时瑞马唑仑的剂量在生理盐水组、瑞芬太尼-1组和瑞芬太尼-2组分别为12（11，13）mg、9.6（8.7，11）mg和8.9（7.9，10）mg（P < 0.05）。各组之间手术和麻醉的特征无显著差异。
结论
瑞芬太尼可增强宫腔镜检查患者麻醉诱导期间瑞马唑仑的镇静效果。
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