雷马唑仑与咪达唑仑用于老年患者全身麻醉的疗效和安全性比较:一项随机对照试验。

IF 2 3区 医学 Q2 ANESTHESIOLOGY
Yang Wan-Jun, Geng Zhi-Long, Gao Yuan-Yuan, Cui Chao-Yuan, Chen Zheng-Ze, Tian Zi-Wei, Guo Xi-Lin, Zhang Ya-Nan, Wang Lu, Huo Rui, Ma Chen-Wei, Niu Jing
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引用次数: 0

摘要

背景:老年患者是围手术期风险较高的弱势群体。因此,减少麻醉时间是很重要的。雷马唑仑是一种苯二氮卓类镇静剂,通常用于全身麻醉的诱导和维持,因为它具有快速的诱导和快速的恢复。大多数报告都集中在非老年患者身上。目的:比较65岁以上患者接受雷马唑仑与咪达唑仑全麻患者的意识丧失时间、PACU停留时间和不良事件发生率。方法:本研究于2022年2月至2023年3月在一所大学医院进行。我们纳入了100例65岁或以上的患者,他们计划在全身麻醉下进行手术。将患者分为咪达唑仑组和雷马唑仑组,每组50例。主要结果是失去意识的时间。次要结果包括拔管时间和PACU停留时间。我们还记录了氟马西尼的使用百分比和不良事件的发生率。结果:96例全麻手术患者的临床资料纳入最终分析,其中雷马唑仑组46例,咪达唑仑组50例。雷马唑仑组至意识丧失时间为304 (222,330)s,咪达唑仑组为95 (67,25)s,差异有统计学意义(p = 0.000)。雷马唑仑组拔管时间为24.93±11.617 min,咪达唑仑组为34.88±19.740 min,差异有统计学意义(p = 0.003)。雷马唑仑组PACU停留时间为55 (48,64)min,咪达唑仑组为65 (55,85)min,差异有统计学意义(p = 0.001)。雷马唑仑组氟马西尼使用率为6%,咪达唑仑组为20%,差异有统计学意义(p = 0.003)。结论:雷马唑仑全身麻醉在老年手术患者中是安全有效的。雷马唑仑组拔管时间明显短于咪达唑仑组,PACU住院时间明显短于咪达唑仑组,氟马西尼使用率明显低于咪达唑仑组。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative study of the efficacy and safety of remimazolam and midazolam for general anesthesia in elderly patients: a randomized controlled trial.

Background: Elderly patients are a vulnerable group with high perioperative risks. Thus, reducing the duration of anesthesia is important. Remimazolam is a benzodiazepine sedative commonly used for the induction and maintenance of general anesthesia given its rapid induction and rapid recovery. Most reports have focused on nonelderly patients.

Aim: To compare the time to loss of consciousness, length of PACU stay and incidence of adverse events in patients older than 65 years who received remimazolam for general anesthesia with those of patients who received midazolam.

Methods: This study was conducted at a university hospital between February 2022 and March 2023. We included 100 patients aged 65 years or older who were scheduled for surgery under general anesthesia. Patients were divided into 2 groups, namely, the midazolam group and the remimazolam group, with 50 patients in each group. The primary outcome was the time to loss of consciousness. The secondary outcomes included the time to extubation and length of PACU stay. We also recorded the percentage of flumazenil used and incidence of adverse events.

Results: Clinical data from 96 patients who were scheduled for surgery under general anesthesia were included in the final analysis, with 46 patients in the remimazolam group and 50 patients in the midazolam group. The time to loss of consciousness was 304 (222, 330) s in the remimazolam group and 95 (67, 25) s in the midazolam group, and the difference was significant (p = 0.000). The time to extubation was 24.93 ± 11.617 min in the remimazolam group and 34.88 ± 19.740 min in the midazolam group, revealing a significant difference (p = 0.003). The length of PACU stay was 55 (48, 64) min in the remimazolam group and 65 (55, 85) min in the midazolam group, and the difference was significant (p = 0.001). The percentage of flumazenil used was 6% in the remimazolam group and 20% in the midazolam group, and the difference was significant (p = 0.003).

Conclusion: General anesthesia with remimazolam has been shown to be effective and safe for surgery in elderly patients. The time to extubation was significantly shorter, length of PACU stay was shorter, and percentage of flumazenil used was lower in the remimazolam group than in the midazolam group.

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