瑞马唑仑舒适化麻醉在口腔手术中的应用效果观察OA

Objective Exploring the effects of remimazolam comfort anaesthesia in oral surgery.Methods 135 patients who underwent oral surgery in Hebei PetroChina Central Hospital from March 2023 to February 2024 were selected and divided into propofol group(n=67)and remimazolam group(n=68)using randomised two-colour balloon method,after propensity score matching,a total of 96 patients were included,48 in both the propofol and remimazolam groups.General data of patients were collected and the level of pain and sedation was assessed at 1 h,6 h,12 h and 24 h postoperatively and the level of comfort was assessed at 6 h,12 h and 24 h postoperatively in both groups;the serum levels of pain mediators[5-Hydroxytryptamine(5-HT),β-endorphin(β-EP),Prostaglandin E2(PGE2)],and stress factors[Norepinephrine(NE),Angiotensin Ⅱ(Ang Ⅱ),Cortisol(Cor)]were examined in the patients of the two groups preoperatively and at 24 h postoperatively.Generalised estimating equations(GEE)were used to assess the degree of influence of different anaesthetic regimens on patients'clinical anaesthesia-related indexes,and the occurrence of adverse events in the two groups was counted.Results The VAS scores of patients in both groups showed a tendency to first increase then decrease within 24 h postoperatively,and the remimazolam group was lower than the propofol group(P＜0.05).The RSS scores showed a decreasing trend,and the remimazolam group was lower than the propofol group(P＜0.05).The BCS scores showed an increasing trend,and the remimazolam group was higher than the propofol group(P＜0.05).Preoperatively,there was no significant difference between the two groups when comparing the levels of pain mediators and stress factors(P＞0.05),at 24 h postoperatively,the levels of 5-HT,β-EP,PGE2,NE,Ang Ⅱ,and Cor were significantly higher in both groups compared with preoperative levels,and were significantly higher in the propofol group than in the remimazolam group(P＜0.05).The results of the GEE equation showed that the differences in the measured values of 5-HT,β-EP,PGE2,NE,Ang Ⅱ,and Cor levels between the propofol and remimazolam groups at different time points were statistically significant(P＜0.05),and the interactions between the groups of indicators with time were statistically significant(P＜0.05).The rate of adverse events was significantly lower in patients in the remimazolam group than in the propofol group(P＜0.05).Conclusion The application of remimazolam in general anaesthesia for oral and maxillofacial surgery can obtain better postoperative analgesia and sedation,with higher postoperative comfort for patients and lower incidence of anaesthetic adverse events,which has a better safety of clinical application.