文献类型：期刊文献

中文题名：瑞马唑仑复合丙泊酚用于无痛人工流产术的效果

英文题名：Effect of remimazolam combined with propofol on painless abortion

作者：张森兵[1,2];安池冰[1];周婷[2];张亚妮[2];张郃[1];阎文军[3]

第一作者：张森兵

机构：[1]咸宁市中心医院麻醉科,湖北科技学院附属第一医院,咸宁437100;[2]甘肃中医药大学第一临床医学院,兰州730000;[3]甘肃省人民医院麻醉科,甘肃中医药大学第一临床医学院,兰州730000

第一机构：咸宁市中心医院麻醉科,湖北科技学院附属第一医院,咸宁437100

年份：2023

卷号：44

期号：4

起止页码：380

中文期刊名：国际麻醉学与复苏杂志

外文期刊名：International Journal of Anesthesiology and Resuscitation

收录：CSTPCD

基金：国家自然科学基金(81860233)。

语种：中文

中文关键词：流产,人工;瑞马唑仑;丙泊酚;情绪

外文关键词：Abortion,induced;Remimazolam;Propofol;Emotions

摘要：目的评价瑞马唑仑复合丙泊酚用于无痛人工流产术的效果。方法选择拟行无痛人工流产术的患者210例,按随机数字表法分为3组(每组70例):瑞马唑仑组(R组)、丙泊酚组(P组)、瑞马唑仑复合丙泊酚组(RP组)。R组给予瑞马唑仑0.2 mg/kg,P组给予丙泊酚2 mg/kg,RP组给予瑞马唑仑0.1 mg/kg+丙泊酚1.0 mg/kg。术中根据需要R组每次追加瑞马唑仑0.05 mg/kg,P组和RP组每次追加丙泊酚0.5 mg/kg。记录3组患者麻醉前(T_(0))、诱导完成1.5 min(T_(1))、诱导完成3.5 min(T_(2))、手术结束(T_(3))时的MAP、心率、SpO_(2),记录3组患者麻醉起效时间、苏醒时间及不良反应(术中体动、注射痛、低血压、呼吸抑制、术后恶心呕吐、术中知晓、过敏)发生情况。于术前15 min和术后45 min采用正负性情绪量表(Positive and Negative Affect Scale,PANAS)评定患者的正负性情绪量值。结果P组、RP组苏醒时间短于R组(P<0.05),3组患者麻醉起效时间差异无统计学意义(P>0.05);T_(1)时R组、RP组MAP、心率、SpO_(2)高于P组(P<0.05),T_(0)、T_(2)、T_(3)时3组患者MAP、心率、SpO_(2)差异无统计学意义(P>0.05);R组和RP组低血压、呼吸抑制、注射痛发生率低于P组(P<0.05),R组术中体动发生率高于P组和RP组(P<0.05),3组患者术中知晓、过敏、恶心呕吐发生率差异无统计学意义(P>0.05);3组患者术后负性情绪量值均低于术前(P<0.05),术后正性情绪量值高于术前(P<0.05),RP组术后正性情绪量值高于R组和P组(P<0.05)。结论瑞马唑仑复合丙泊酚可安全、有效地用于无痛人工流产术,麻醉效果优于单用丙泊酚或瑞马唑仑,具有静脉注射痛发生率低、血流动力学影响小、患者术后正性情绪量值高等特点。
Objective To evaluate the effect of remimazolam combined with propofol on painless abortion.Methods A total of 210 patients who were scheduled for painless abortion were enrolled.According to the random number table method,they were divided into three groups(n=70):a remimazolam group(group R),a propofol group(group P)and a remimazolam combined with propo?fol group(group RP).Group R was administered with 0.2 mg/kg remimazolam,and group P was given 2 mg/kg propofol,while group RP received 0.1 mg/kg remimazolam plus 1.0 mg/kg propofol.During operation,0.05 mg/kg remimazolam was added to group R and 0.5 mg/kg propofol to group P and group RP if necessary.Then,their mean arterial pressure(MAP),heart rate and pulse oxygen saturation(SpO_(2))were recorded before anesthesia(T_(0)),1.5 min after induction(T_(1)),3.5 min after induction(T_(2)),and at the end of surgery(T_(3)).The onset time of anesthesia,time for emergence from anesthesia,and adverse reactions(intraoperative motor responses,injection pain,hypotension,respiratory inhibition,postoperative nausea and vomiting,intraoperative awareness,and allergy)were recorded.The Positive and Negative Affect Scale(PANAS)was used to evaluate the patients'positive and negative emotions 15 min before surgery and 45 min after surgery.Results Compared with group R,the time for emergence from anesthesia was reduced in group P and group RP(P<0.05),and there was no statistical difference in the onset time of anesthesia among the three groups(P>0.05).At T_(1),group R and group RP showed higher MAP,heart rate and SpO_(2) than group P(P<0.05),but no statistical differences were found in MAP,heart rate and SpO_(2) at T_(0),T_(2) and T_(3)(P>0.05).Compared with group P,the incidences of hypotension,respiratory inhabitation andinjection pain were reduced in group R and group RP(P<0.05).Group R presented a higher incidence of intraoperative motor response than group P and group RP(P<0.05).There were no statistical differences as to the incidences of intraoperative awareness,allergy,nausea and vomiting among the three groups(P>0.05).Furthermore,all the three groups showed lower postoperative negative emotion than that before surgery(P<0.05),and higher postoperative positive emotion than that before surgery(P<0.05).Group RP showed higher postoperative positive emotion than group R and group P(P<0.05).Conclusions Remimazolam combined with propofol is safe and effective in painless abortion,with superior anesthetic effect to propofol or remimazolam alone,and characterized by a low incidence of intravenous pain,little hemodynamic effect,and increased postoperative positive emotion.