摘要
目的评价瑞马唑仑用于结直肠肿瘤患者麻醉诱导的效果。方法本研究为前瞻性研究。选取本院2023年6月至11月择期全麻下行结直肠肿瘤手术患者82例,年龄18~80岁,BMI 18.5~28.0 kg/m^(2),ASA分级Ⅰ-Ⅲ级。采用随机数字表法分为2组(n=41):丙泊酚组(P组)和瑞马唑仑组(R组)。P组静脉注射丙泊酚1.5 mg/kg,R组静脉注射瑞马唑仑0.3 mg/kg,BIS值≤60时静脉注射舒芬太尼0.5μg/kg和顺阿曲库铵0.2 mg/kg。于麻醉诱导前(T_(0))、诱导后3 min(T_(1))、气管插管即刻(T_(2))和插管后5 min(T_(3))时记录HR和MAP。记录诱导期低血压、高血压、心动过速、心动过缓的发生情况、血管活性药使用情况以及注射痛发生情况,记录意识消失时间、从给药开始至BIS值≤60的时间、给药开始至气管插管时间、气管插管即刻BIS值>60的发生情况和补救镇静情况。结果最终纳入80例患者,其中P组40例,R组40例。与P组比较,R组T_(1)和T_(2)时MAP和HR升高,低血压和心动过缓发生率降低,从给药开始至BIS值≤60的时间延长(P<0.05),其余指标差异无统计学意义(P>0.05)。结论瑞马唑仑0.3 mg/kg可安全有效地用于结直肠肿瘤患者的麻醉诱导,相较于丙泊酚1.5 mg/kg,维持血流动力学稳定的效果更好。
ObjectiveTo evaluate the efficacy of remimazolam for induction of anesthesia in patients with colorectal cancer.MethodsThis was a prospective study.Eighty-two patients scheduled for elective colon and rectal tumor surgery under general anesthesia from June to November 2023 at our hospital,aged 18-80 yr,with body mass index of 18.5-28.0 kg/m^(2),of American Society of Anesthesiologists Physical Status classificationⅠ-Ⅲ,were divided into 2 groups(n=41 each)using a random number table method:propofol group(group P)and remimazolam group(group R).Propofol 1.5 mg/kg was intravenously injected in group R and remimazolam 0.3 mg/kg was intravenously injected in group P.When the bispectral index(BIS)value≤60,sufentanil 0.5μg/kg and cisatracurium 0.2 mg/kg were intravenously injected in both groups.Heart rate and mean arterial pressure were recorded before induction of anesthesia(T_(0)),3 min after induction(T_(1)),immediately after intubation(T_(2)),and 5 min after tracheal intubation(T_(3)).The occurrence of hypotension,hypertension,tachycardia and bradycardia during induction,use of vasoactive drugs,and injection pain were recorded.The time to loss of consciousness,time from the beginning of administration to BIS value≤60,time from the beginning of administration to tracheal intubation,occurrence of BIS value>60 immediately after intubation and rescue sedation were recorded.ResultsEighty patients were finally included,with 40 in group P and 40 in group R.Compared with group P,the heart rate and mean arterial pressure were significantly increased at T_(1) and T_(2),the incidence of hypotension and bradycardia was decreased,and the time from the beginning of administration to BIS value≤60 was prolonged(P<0.05),and no statistically significant changes were found in the other parameters in group R(P>0.05).ConclusionsRemimazolam 0.3 mg/kg can be safely and effectively used for anesthesia induction and provides better efficacy in maintaining hemodynamic stability when compared with propofol 1.5 mg/kg in patients with colorectal cancer.
作者
张茜
戎元元
胡涛
刘晓明
张凤姣
张振亚
付建峰
刘华琴
Zhang Xi;Rong Yuanyuan;Hu Tao;Liu Xiaoming;Zhang Fengjiao;Zhang Zhenya;Fu Jianfeng;Liu Huaqin(Department of Anesthesiology,The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;The Second Department of General Surgery,The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2024年第8期967-971,共5页
Chinese Journal of Anesthesiology
基金
河北省卫健委重点科技研究计划(20211163,20220163)
河北省自然科学基金(H2020206590)。
关键词
苯二氮类
结直肠肿瘤
麻醉诱导
Benzodiazepines
Colorectal neoplasms
Anesthesia induction
