瑞马唑仑复合地氟烷全身麻醉联合氟马西尼拮抗在眼科日间手术中的应用

doi:10.3969/j.issn.1006-5725.2024.04.017

Abstract

Abstract:

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.

Key words: remimazolam, desflurane, flumazenil, propofol, day surgery

CLC Number:

R614

Chunhua HU,Guyan WANG,Huijun WANG,Chunhua XI,Congya ZHANG,Lili. WU. Effect of remimazolam combined with desflurane and flumazenil antagonism for anesthesia during ophthalmic day surgery[J]. The Journal of Practical Medicine, 2024, 40(4): 537-542.

Figures/Tables 5

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References 18

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项目	P组（n = 32）	R组（n = 32）	t/χ²/Z值	P值
年龄（x ± s，岁）	51.59 ± 8.55	50.34 ± 7.29	0.630	0.531
性别（例）			0.254	0.614
男	15	13
女	17	19
BMI（x ± s，kg/m²）	23.97 ± 3.00	24.80 ± 2.74	-1.160	0.251
ASA分级（例）			-1.070	0.285
Ⅰ级	3	6
Ⅱ级	29	26
手术时间（x ± s，min）	99.59 ± 16.72	95.84 ± 11.65	1.041	0.302
麻醉时间（x ± s，min）	115.28 ± 16.45	111.06 ± 12.36	1.160	0.251
术中输液量（x ± s，mL）	1 007.81 ± 145.42	960.94 ± 123.61	1.389	0.170

组别	例数	苏醒时间	拔管时间	出室时间	PACU停留时间
P组	32	8.64 ± 2.77	9.90 ± 2.81	11.74 ± 3.11	33.18 ± 5.12
R组	32	4.11 ± 1.17	4.61 ± 1.11	6.60 ± 2.01	31.53 ± 5.97
t值		11.118	13.485	12.464	1.691
P值		< 0.001	< 0.001	< 0.001	0.096

组别	例数	T₀	T₁	T₂	T₃
P组	32	98.09 ± 3.73	80.00 ± 7.35^*	87.31 ± 2.91^*	74.13 ± 7.60^*
R组	32	96.59 ± 3.89	86.34 ± 4.84^*	91.28 ± 3.08^*	78.47 ± 7.51^*
t值		1.574	4.079	-5.295	-2.30
P值		0.120	< 0.001	< 0.001	< 0.001
组别	例数	T₄	T₅	T₆	T₇
P组	32	79.53 ± 4.93^*	87.41 ± 5.33^*	95.09 ± 4.25	95.53 ± 4.97
R组	32	85.06 ± 5.96^*	90.59 ± 5.53^*	96.00 ± 3.98	94.13 ± 4.53
t值		-4.04	-2.347	-0.881	1.183
P值		< 0.001	0.022	0.382	0.241

组别	例数	T₀	T₁	T₂	T₃
P组	32	80.63 ± 3.85	73.59 ± 6.29^*	76.72 ± 5.73^*	72.66 ± 6.80^*
R组	32	79.19 ± 6.29	78.66 ± 5.01	81.94 ± 5.27	77.75 ± 4.39^*
t值		1.103	-3.563	-3.791	-3.563
P值		0.275	0.001	< 0.001	0.001
组别	例数	T₄	T₅	T₆	T₇
P组	32	70.47 ± 7.04^*	70.84 ± 7.16^*	78.41 ± 8.32	77.22 ± 7.43
R组	32	74.16 ± 7.32^*	77.22 ± 5.32^*	78.75 ± 7.22	78.06 ± 7.91
t值		-2.054	-2.716	-0.177	0.603
P值		0.044	0.009	0.860	0.549

组别	例数	低血压	心动过速	心动过缓	术后头晕	术后恶心呕吐
P组	32	18（56.3）	0（0）	12（37.5）	0（0）	2（6.3）
R组	32	4（12.5）	3（9.4）	3（9.4）	1（3.1）	3（9.4）
χ²值		13.364	1.399	7.053	0.000	0.000
P值		< 0.001	0.237	0.008	1.000	1.000

Effect of remimazolam combined with desflurane and flumazenil antagonism for anesthesia during ophthalmic day surgery

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