比较雷马唑仑和丙泊酚在无痛宫腔镜微创手术中的麻醉效果

IF 0.9 4区医学 Q3 SURGERY

Annali italiani di chirurgia Pub Date : 2024-04-20 DOI:10.62713/aic.3291

Fei Gao, Yanjun Xie, Hengwei Zhu, Chen Chen, Hongyan Fu

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The patients were divided into the remimazolam group (group R, n = 55) and the propofol group (group P, n = 55) according to the main anesthetic drugs used during the operation. The changes in heart rate (HR), mean arterial pressure (MAP), blood oxygen saturation (SpO2), and respiratory rate (RR) at the time of entry (T0), modified vigilance/sedation score (MOAA/S) 0 (T1), cervical dilation (T2), end of the operation (T3) and anesthesia recovery (T4) were compared between the two groups. Anesthesia induction time, operation time, and anesthesia recovery time were compared between the two groups, and the incidence of intraoperative and postoperative adverse reactions was compared between the two groups. \nResults: HR, MAP, and SpO2 in group R were significantly higher than those in group P at T1, T2, T3, and T4 (p < 0.05), and there was no significant difference in RR between the two groups (p > 0.05). 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引用次数: 0

摘要

目的：宫腔镜手术会刺激支配子宫的自主神经，使受术者产生强烈的不适感和疼痛感，严重者会引起血压下降、心率减慢、心律失常甚至心跳骤停，因此大多数患者需要麻醉干预。本研究旨在回顾性比较瑞美唑仑和异丙酚在无痛宫腔镜微创手术中的麻醉效果，探讨瑞美唑仑的安全性和有效性。研究方法收集2023年1月至2023年6月在我院接受无痛宫腔镜微创手术的110例女性患者的临床资料。根据手术中使用的主要麻醉药物，将患者分为雷马唑仑组（R 组，n = 55）和丙泊酚组（P 组，n = 55）。比较两组在入室（T0）、改良警觉/镇静评分（MOAA/S）0（T1）、宫颈扩张（T2）、手术结束（T3）和麻醉恢复（T4）时的心率（HR）、平均动脉压（MAP）、血氧饱和度（SpO2）和呼吸频率（RR）的变化。比较两组的麻醉诱导时间、手术时间和麻醉恢复时间，并比较两组术中和术后不良反应的发生率。结果R组在T1、T2、T3和T4的HR、MAP和SpO2明显高于P组（P＜0.05），两组的RR无明显差异（P＞0.05）。R 组 T1 和 T2 时的 HR、MAP 和 SpO2 明显低于 T0 时（P < 0.05），该组不同时间点的 RR 无明显差异（P > 0.05）。P组在T1、T2、T3和T4时的HR、MAP和SpO2均明显低于T0时（P＜0.01），同组不同时间点的RR无明显差异（P＞0.05）。R 组的麻醉诱导时间比 P 组更长，而 R 组的麻醉恢复时间比 P 组更短（P < 0.05）。R 组低血压、心动过缓、低血氧饱和度、呼吸抑制和注射疼痛的发生率明显低于 P 组（P < 0.05）。结论与异丙酚相比，在宫腔镜微创手术中使用6 mg-kg-1-h-1剂量的雷马唑仑静脉诱导和1-2 mg-kg-1-h-1剂量的麻醉维持对血流动力学的影响更小，恢复时间更快，不良反应发生率更低。雷马唑仑可安全有效地用于此类手术。

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To Compare the Anesthetic Effect of Remimazolam and Propofol in Painless Hysteroscopic Minimally Invasive Surgery

Objective: Hysteroscopic surgery will stimulate the autonomic nerves innervating the uterus, causing intense discomfort and pain in the examined person, and in severe cases, it will cause blood pressure drop, heart rate slowing, arrhythmia and even cardiac arrest, so most patients need anesthetic intervention. This study to retrospectively compare the anesthetic effect of remimazolam and propofol in minimally invasive painless hysteroscopic surgery and to explore the safety and efficacy of remimazolam. Methods: The clinical data of 110 female patients who underwent painless hysteroscopic minimally invasive surgery in our hospital from January 2023 to June 2023 were collected. The patients were divided into the remimazolam group (group R, n = 55) and the propofol group (group P, n = 55) according to the main anesthetic drugs used during the operation. The changes in heart rate (HR), mean arterial pressure (MAP), blood oxygen saturation (SpO2), and respiratory rate (RR) at the time of entry (T0), modified vigilance/sedation score (MOAA/S) 0 (T1), cervical dilation (T2), end of the operation (T3) and anesthesia recovery (T4) were compared between the two groups. Anesthesia induction time, operation time, and anesthesia recovery time were compared between the two groups, and the incidence of intraoperative and postoperative adverse reactions was compared between the two groups. Results: HR, MAP, and SpO2 in group R were significantly higher than those in group P at T1, T2, T3, and T4 (p < 0.05), and there was no significant difference in RR between the two groups (p > 0.05). HR, MAP, and SpO2 at T1 and T2 were significantly lower than those at T0 in group R (p < 0.05), and RR at different time points in the group had no significant difference (p > 0.05). HR, MAP, and SpO2 at T1, T2, T3, and T4 were significantly lower than those at T0 in group P (p < 0.01), and RR at different time points in the same group had no significant difference (p > 0.05). The anesthesia induction time in group R was more prolonged than in group P, and the anesthesia recovery time in group R was shorter than in group P (p < 0.05). The incidences of hypotension, bradycardia, low oxygen saturation, respiratory depression, and injection pain in group R were significantly lower than those in group P (p < 0.05). Conclusion: Intravenous induction of remimazolam at 6 mg·kg-1·h-1 and maintenance of anesthesia at 1–2 mg·kg-1·h-1 have less effect on hemodynamics, faster recovery time and lower incidence of adverse reactions compared with propofol when used in minimally invasive hysteroscopic surgery. Remimazolam can be safely and effectively used in this kind of surgery.

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来源期刊

Annali italiani di chirurgia 医学-外科

CiteScore

0.90

自引率

12.50%

发文量

116

审稿时长

>12 weeks

期刊介绍： Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.