瑞马唑仑用于气管插管全身麻醉诱导对患者血流动力学的影响及安全性OA
Effect of Remimazolam on hemodynamics and its safety profile in patients undergoing induction of general anesthesia for tracheal intubation
目的 探讨瑞马唑仑与丙泊酚在气管插管全身麻醉诱导期间对患者心脏功能及血流动力学稳定性的影响.方法 选取2023年1月—2025年1月于唐山市妇幼保健院择期行全身麻醉下妇科手术的患者123例为研究对象,采用随机数字表法分为瑞马唑仑组61例和丙泊酚组62例.瑞马唑仑组患者接受0.3 mg/kg甲苯磺酸瑞马唑仑麻醉诱导,丙泊酚组患者接受2 mg/kg丙泊酚麻醉诱导,超声检查完成后静脉注射舒芬太尼+苯磺酸顺式阿曲库铵,待诱导药物完全起效后可视喉镜下行气管插管.分别于给药前、给药后行经胸超声心动图检查,记录患者超声心动图血流动力学参数及给药前、给药后、插管前、插管后即刻、插管后3 min时心率、平均动脉压(MAP),统计麻醉诱导期间不良事件发生情况.结果 给药后,瑞马唑仑组心输出量(CO)、二尖瓣环舒张早期峰值速度/二尖瓣环舒张晚期峰值速度值(Ea/Aa)较给药前下降,丙泊酚组左心室射血分数(LVEF)、CO、每搏量和Ea/Aa较给药前下降,且瑞马唑仑组LVEF、CO、每搏量均高于丙泊酚组(P＜0.05).给药后,瑞马唑仑组MAP高于丙泊酚组(P＜0.05);两组不同时间点心率比较差异无统计学意义(P＞0.05).瑞马唑仑组均未发生注射痛、低血压,丙泊酚组发生注射痛和低血压各6例(9.68％).瑞马唑仑组注射痛、低血压发生率均低于丙泊酚组(P＜0.05),其他不良事件发生率比较差异无统计学意义(P＞0.05).结论 瑞马唑仑对气管插管全身麻醉诱导患者的血流动力学影响较小,安全性更高.
Objective To investigate the effects of Remimazolam and Propofol on hemodynamic stability and its safety profile in patients undergoing induction of general anesthesia for tracheal intubation.Methods From January 2023 to January 2025,123 patients undergoing gynecological surgery under general anesthesia in Tangshan Maternal and Child Health Hospital were selected as the study subjects.According to the random number table method,they were divided into Remimazolam group(n=61)and Propofol group(n=62).Patients in Remimazolam group received 0.3 mg/kg Remimazolam Tosilate for anesthesia induction,and patients in Propofol group received 2 mg/kg Propofol for anesthesia induction.After ultrasound examination,Sufentanil and Cisatracurium Besilate were injected intravenously,and tracheal intubation was performed under a video laryngoscopy after the induction agents had fully taken effect.Transthoracic echocardiography was performed before and after administration,and the hemodynamic parameters of echocardiography,heart rate(HR)and mean arterial pressure(MAP)before administration,after administration,before intubation,immediately after intubation,and at 3 min after intubation were recorded.Adverse events during anesthesia induction were recorded.Results After administration,the cardiac output(CO)and the ratio of early diastolic mitral annular velocity to late diastolic mitral annular velocity(Ea/Aa)in the Remimazolam group were lower than those before administration,and the left ventricular ejection fraction(LVEF),CO,stroke volume and Ea/Aa in the Propofol group were lower than those before administration,while LVEF,CO and stroke volume in Remimazolam group were higher than those in Propofol group(P＜0.05).After administration,MAP in Remimazolam group was higher than that in Propofol group(P＜0.05).There was no significant difference in HR between the two groups at different time points(P＞0.05).No injection pain or hypotension occurred in Remimazolam group,whereas in the Propofol group,injection pain and hypotension occurred in 6 patients respectively(9.68％).The incidence of injection pain and hypotension in Remimazolam group was lower than that in Propofol group(P＜0.05),and there was no significant difference in the incidence of other adverse events between the two groups(P＞0.05).Conclusion Remimazolam has less hemodynamic impact on patients undergoing general anesthesia induction for tracheal intubation,with favorable safety profile.
石东海;张宇;白耀武;李顺义;郝妍妍
唐山市妇幼保健院麻醉科,河北唐山 063000唐山市妇幼保健院超声科,河北唐山 063000唐山市妇幼保健院麻醉科,河北唐山 063000唐山市妇幼保健院麻醉科,河北唐山 063000唐山市妇幼保健院麻醉科,河北唐山 063000
瑞马唑仑麻醉诱导气管插管心输出量二尖瓣环舒张早期峰值速度二尖瓣环舒张晚期峰值速度值左心室射血分数低血压
Remimazolamanesthesia inductiontracheal intubationcardiac outputearly diastolic mitral annular velocitylate diastolic mitral annular velocityleft ventricular ejection fractionhypotension
《临床误诊误治》 2026 (16)
57-62,6
河北省医学科学研究课题计划项目(20241254)
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