目的 探讨瑞马唑仑复合地氟烷全身麻醉联合氟马西尼拮抗用于眼科日间手术的麻醉效果。 方法 前瞻性随机对照试验，选择择期喉罩全身麻醉的眼科日间手术患者64例，随机分为丙泊酚组（n = 32）和瑞马唑仑组（n = 32）。丙泊酚组给予丙泊酚麻醉诱导，丙泊酚复合地氟烷麻醉维持；瑞马唑仑组给予瑞马唑仑麻醉诱导，瑞马唑仑复合地氟烷麻醉维持，术毕静脉注射氟马西尼拮抗。两组术中均持续静脉输注瑞芬太尼。主要结局为苏醒时间，次要结局包括术中血液动力学变化、拔管时间、离开手术室的时间、术后恢复室（PACU）停留时间以及围术期其他不良反应的发生情况。 结果 瑞马唑仑组的苏醒时间、拔管时间和离开手术室时间均显著短于丙泊酚组（P < 0.05）［分别为（4.11 ± 1.17）min vs. （8.64 ± 2.77）min、（4.61 ± 1.11）min vs. （9.90 ± 2.81）min和（6.60 ± 2.01）min vs. （11.74 ± 3.11）min］；瑞马唑仑组术中低血压和心动过缓的发生率均显著低于丙泊酚组，差异有统计学意义（P < 0.05）；两组术后PACU停留时间及术后并发症发生率差异无统计学意义（P > 0.05）。 结论 瑞马唑仑复合地氟烷全身麻醉联合氟马西尼拮抗用于眼科日间手术麻醉管理，可显著缩短患者的苏醒时间及拔管时间，有助于维持血流动力学稳定，不良反应少，提高眼科日间手术的安全性，值得临床推广应用。

Objective To evaluate the effect of remimazolam combined with desflurane and flumazenil antagonism for anesthesia during ophthalmic day surgery. Methods This is a prospective randomized controlled trial. A total of 64 patients undergoing elective general anesthesia with laryngeal mask during ophthalmic day surgery were selected and randomly assigned to propofol group （n = 32） and remimazolam group （n = 32）. The propofol group was given propofol anesthesia induction and propofol combined with diflurane anesthesia maintenance； the remazolam group was given remazolam anesthesia induction and remazolam combined with diflurane anesthesia maintenance， and flumazenil antagonism was given intravenously at the end of the operation. Continuous intravenous infusion of remifentanil was administered during surgery in both groups. The primary outcome was emergence time. The secondary outcome included changes in intraoperative hemodynamic parameters，extubation time，time to leaving the operating room， duration of postoperative recovery room （PACU） stay， and the occurrence of other perioperative adverse reactions. Results Emergence time， extubation time， and time to leaving the operating room in remimazolam group were significantly shorter than those in group propofol （P < 0.05） ［（4.11 ± 1.17） vs. （8.64 ± 2.77）min， （4.61 ± 1.11） vs. （9.90 ± 2.81）min and （6.60 ± 2.01） vs. （11.74 ± 3.11）min， respectively］. The incidences of intraoperative hypotension and bradycardia in the remimazolam group were significantly lower than that in the propofol group （P < 0.05）； There was no statistically difference in the duration of PACU stay and the incidence of postoperative complications between the two groups（P > 0.05）. Conclusion Remimazolam combined with desflurane general anesthesia and flumazenil antagonism for anesthesia management in ophthalmic day surgery could significantly shorten the time of emergence and extubation， help to maintain hemodynamic stability with fewer adverse reactions， and improve the safety of ophthalmic daytime surgery， which is worthy of clinical promotion and application.