雷马唑仑用于心脏手术和接受非心脏手术的心脏病患者的麻醉和镇静:系统叙事混合综述。

IF 2.9 3区 医学 Q1 ANESTHESIOLOGY
Minerva anestesiologica Pub Date : 2024-07-01 Epub Date: 2024-05-21 DOI:10.23736/S0375-9393.24.17943-6
Jacopo D'Andria Ursoleo, Margherita Licheri, Gaia Barucco, Rosario Losiggio, Giovanna Frau, Marina Pieri, Fabrizio Monaco
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引用次数: 0

摘要

简介雷马唑仑是一种超短效苯二氮卓类药物,被多个国家认可并批准用作麻醉剂和镇静剂,具有独特的药代动力学特征,具有起效快、作用时间短、恢复快等优点。与其他镇静剂相比,这些特性可能有助于增强血液动力学的稳定性并降低呼吸抑制的风险:我们首次进行了全面系统的叙述性综述,以评估雷马唑仑在心脏手术中的作用和潜在应用。从2021年到2023年发表的21篇研究报告深入探讨了雷马唑仑在开放性心脏手术、心导管或电生理学实验室以及接受非心脏手术的高风险心血管患者中的应用:总体而言,与其他催眠药物相比,使用雷马唑仑显然具有更佳的血液动力学稳定性。然而,关于使用雷马唑仑降低术后谵妄发生率以及麻醉诱导和维持剂量的研究结果并不一致:尽管雷马唑仑在心脏手术患者和接受非心脏手术的高风险心血管患者的麻醉诱导和维持方面具有潜在的安全性、有效性和易用性,但仍需进一步研究特定患者亚群(如老年人或紧急手术),以确定最佳剂量范围,适应不同的临床情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Remimazolam for anesthesia and sedation in cardiac surgery and for cardiac patients undergoing non-cardiac surgery: a systematic-narrative hybrid review.

Introduction: Remimazolam, an ultra-short-acting benzodiazepine recognized and approved as an anesthetic and sedative in multiple countries, offers a distinctive pharmacokinetic profile, boasting advantages such as rapid onset, short action duration, and rapid recovery. These attributes may contribute to enhanced hemodynamic stability and a diminished risk of respiratory depression compared to other sedatives.

Evidence acquisition: We conducted the first comprehensive systematically structured narrative review to evaluate the role and potential application of remimazolam in cardiac surgery. Twenty-one studies published from 2021 to 2023 delved into remimazolam's application in open cardiac surgery, cardiac catheterization or electrophysiology laboratories, and high-risk cardiovascular patients undergoing non-cardiac surgery.

Evidence synthesis: Overall, remimazolam usage was apparently linked to potentially superior hemodynamic stability compared to other hypnotic drugs. However, findings regarding the reduction in postoperative delirium incidence with remimazolam and the doses of remimazolam for anesthesia induction and maintenance were inconsistent across the studies.

Conclusions: Though remimazolam has demonstrated potential safety, efficacy, and ease-of-use for both anesthesia induction and maintenance in cardiac surgery patients and high-risk cardiovascular patients undergoing non-cardiac surgery, further research is imperative to delve into specific patient subgroups (e.g., the elderly or emergent procedures) so as to ascertain optimal dose ranges to suit diverse clinical scenarios.

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来源期刊
Minerva anestesiologica
Minerva anestesiologica 医学-麻醉学
CiteScore
4.50
自引率
21.90%
发文量
367
审稿时长
4-8 weeks
期刊介绍: Minerva Anestesiologica is the journal of the Italian National Society of Anaesthesia, Analgesia, Resuscitation, and Intensive Care. Minerva Anestesiologica publishes scientific papers on Anesthesiology, Intensive care, Analgesia, Perioperative Medicine and related fields. Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors.
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