实用医学杂志 ›› 2024, Vol. 40 ›› Issue (8): 1063-1068.doi: 10.3969/j.issn.1006-5725.2024.08.007

• 专题报道:日间手术麻醉 • 上一篇    

不同性别对日间关节镜手术患者瑞马唑仑使用剂量及术后恢复质量的影响

汤黎黎1,孙月1,刘学胜1,陆姚1,2()   

  1. 1.安徽医科大学第一附属医院,麻醉科,(合肥 230022 )
    2.安徽医科大学第一附属医院,日间手术中心,(合肥 230022 )
  • 收稿日期:2023-10-11 出版日期:2024-04-25 发布日期:2024-04-19
  • 通讯作者: 陆姚 E-mail:luyao@ahmu.edu.cn
  • 基金资助:
    安徽医科大学第一附属医院高峰学科-麻醉与药理学共建项目(9001001813);白求恩公益基金-围术期镇痛镇静研究项目(BCF-RF-WSQZTZJ-202011-057)

The gender⁃specific effects on doses of remimazolam and quality of postoperative recovery in patients undergoing ambulatory arthroscopic surgery

Lili TANG1,Yue SUN1,Xuesheng LIU1,Yao. LU1,2()   

  1. *.Department of Anesthesiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China
  • Received:2023-10-11 Online:2024-04-25 Published:2024-04-19
  • Contact: Yao. LU E-mail:luyao@ahmu.edu.cn

摘要:

目的 探讨性别对日间关节镜手术患者瑞马唑仑使用剂量以及术后24 h恢复质量(QoR)的影响。 方法 选择预约在日间手术中心进行关节镜半月板修复术的患者50例,按照性别分为两组,其中男25例(M组),女25例(F组)。本研究主要观察两组在麻醉诱导失去意识和术中维持瑞马唑仑剂量的区别,以及采用QoR-15量表、阿森斯失眠(AIS)量表观察性别对术后睡眠和24 h恢复质量的影响。 结果 M组患者失去意识时瑞马唑仑剂量为0.14(0.13,0.15) mg/kg,麻醉维持剂量为0.80(0.60,0.96)mg/(kg·h);F组患者失去意识时瑞马唑仑剂量为0.14(0.12,0.16) mg/kg,麻醉维持剂量为0.90(0.79,1.12)mg/(kg·h),两组患者失去意识与麻醉维持的瑞马唑仑剂量差异均无统计学意义(P > 0.05)。两组对术后第1天睡眠的AIS总分影响差异无统计学意义(P > 0.05),但女性患者较男性患者更易发生低血压和PONV,术后比期望中更早醒及QoR-15总分、生理舒适度分数降低,差异有统计学意义(P < 0.05)。 结论 性别对日间关节镜患者瑞马唑仑麻醉诱导剂量及麻醉维持剂量影响较小,但女性患者术后睡眠清醒时间更早,男性患者术后24 h恢复质量较高。

关键词: 性别, 瑞马唑仑, 日间手术, 关节镜手术, 术后恢复质量

Abstract:

Objective To investigate the effects of gender on dosage of remimazolam and quality of recovery in patients undergoing ambulatory arthroscopic surgery at 24 hours postoperatively. Methods Fifty patients who underwent elective arthroscopic meniscus repair in a daytime surgery center were divided into two groups according to gender: 25 males (group M) and 25 females (group F). The remimazolam dogages of loss of consciousness and anesthesia maintenance were recorded, and the effects of gender on the quality of recovery at 24 hours postoperatively and sleepquality were observed by using QoR-15 scale and Athens Insomnia Scale (AIS). Results The doses of remimazolam at the time of loss of consciousness and anesthesia maintenance for patients were (0.13 and 0.15) mg/kg and 0.80 (0.60 and 0.96) mg/(kg·h) in group M, and 0.14 (0.12 and 0.16) mg/kg and 0.90 (0.79 and 1.12) mg/(kg·h) in group F. There were no statistical differences in the doses of remimazolam between the two groups (P > 0.05). AIS scores did not differ on postoperative day one between the two groups (P > 0.05), but there was a statistically significant difference on final awakening earlier than expectation in the female patients (P < 0.05). Female patients had lower total QoR-15 scores and physiological comfort scores, and higher incidences of hypotension and PONV than male patients (P < 0.05). Conclusions Gender had no significant effects on dosage of remimazolam during anesthesia induction and anesthesia maintenance in the patients receiving daytime arthroscopy. Female patients had final awakening earlier than expectation, and male patients had higher quality of recovery at 24 hours postoperatively.

Key words: gender, remimazolam, daytime surgery, arthroscopic surgery, quality of recovery

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