摘要
目的:评价瑞马唑仑复合依托咪酯用于ASAⅠ级无痛人工流产手术的效果。方法:择期拟行无痛人工流产手术的患者120例,年龄18~50岁,BMI 18~28 kg/m^(2),ASA分级Ⅰ级。采用随机数字表法分为3组(每组40例),瑞马唑仑组(R组)、瑞马唑仑+低剂量依托咪酯组(RE1组)和瑞马唑仑+高剂量依托咪酯组(RE2组)。采用面罩吸氧,静脉注射瑞芬太尼1μg/kg;R组缓慢注射瑞马唑仑0.3 mg/kg;RE1组静脉注射瑞马唑仑0.2 mg/kg,依托咪酯0.1 mg/kg;RE2组静脉注射瑞马唑仑0.2 mg/kg,依托咪酯0.15 mg/kg。记录各组镇静成功率、意识消失时间、意识恢复时间、麻醉恢复室(PACU)停留时间和瑞芬太尼用量;记录术中及术后不良反应发生率;记录苏醒后5 min疼痛评分和离开PACU前患者满意度评分。结果:RE1组和RE2组镇静成功率高于R组,瑞芬太尼用量少于R组(P<0.05)。3组患者意识消失时间、意识恢复时间、PACU停留时间比较,差异无统计学意义(P>0.05)。与R组和RE2组比较,RE1组术中低氧血症发生率降低;与R组比较,RE1组和RE2组术中呃逆发生率降低(P<0.016)。3组患者苏醒后5 min疼痛评分和离开PACU前患者满意度评分比较,差异无统计学意义(P>0.05)。结论:0.2 mg/kg瑞马唑仑复合0.1 mg/kg依托咪酯用于ASAⅠ级患者无痛人工流产手术镇静效果好,且不良反应发生率低。
Aim:To evaluate the efficacy of remimazolam combined with etomidate in painless induced abortion of ASA gradeⅠpatients.Methods:Totally 120 patients,aged 18-50 years,BMI 18-28 kg/m^(2),ASA gradeⅠ,were selected for painless induced abortion.They were divided into 3 groups by random number table method(40 in each group),remimazolam group(group R),remimazolam+low-dose etomidate group(group RE1)and remimazolam+high-dose etomidate group(group RE2).Oxygen was given by mask and remifentanil at 1μg/kg was intravenously injected.Group R was slowly injected with remimazolam 0.3 mg/kg.Group RE1 was injected intravenously with 0.2 mg/kg remimazolam and 0.1 mg/kg etomidate.Group RE2 was injected intravenously with remimazolam 0.2 mg/kg and etomidate 0.15 mg/kg.The success rate of sedation,consciousness loss time,consciousness recovery time,postanesthesia care unit(PACU)residence time and dosage of remifentanil were recorded.The incidence of intraoperative and postoperative adverse reactions were recorded.Pain score 5 minutes after awakening and patient satisfaction score before leaving PACU were recorded.Results:The success rate of sedation in RE1 and RE2 groups was higher than that in group R,and the dosage of remifentanil was lower than that in group R(P<0.05).There was no significant difference in consciousness loss time,consciousness recovery time or PACU residence time among the 3 groups(P>0.05).Compared with group R and group RE2,the incidence of intraoperative hypoxemia in group RE1 decreased;compared with group R,the incidence of hiccup in group RE1 and group RE2 decreased(P<0.016).There was no significant difference in pain score 5 minutes after awakening or patient satisfaction score before leaving PACU among the 3 groups(P>0.05).Conclusion:0.2 mg/kg remimazolam combined with 0.1 mg/kg etomidate is effective for painless abortion of ASA gradeⅠpatients with low incidence of adverse reactions.
作者
渠明翠
程丹
陈嘉琪
王绪林
袁雅卓
邢娜
QU Mingcui;CHENG Dan;CHEN Jiaqi;WANG Xulin;YUAN Yazhuo;XING Na(Department of Anesthesiology,Pain and Perioperative Medicine,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 45005;Henan Province International Joint Laboratory of Pain,Cognition and Emotion,Zhengzhou 450052)
出处
《郑州大学学报(医学版)》
北大核心
2025年第4期515-518,共4页
Journal of Zhengzhou University(Medical Sciences)
基金
河南省卫生健康中青年学科带头人培养项目(HNSWJW-2022023)
北京康盟慈善基金会麻醉与重症科研项目(KM-20230426-01)。
关键词
瑞马唑仑
依托咪酯
人工流产
镇静镇痛
remimazolam
etomidate
induced abortion
sedation and analgesia
