【罂粟摘要】瑞马唑仑与丙泊酚用于全麻诱导期间有效性和安全性的比较

瑞马唑仑与丙泊酚用于全麻诱导期间有效性和安全性的比较

贵州医科大学  麻醉与心脏电生理课题组

翻译：吴学艳   编辑：佟睿   审校：曹莹

背景

瑞马唑仑是一种新型超短效苯二氮卓类麻醉药，在胃肠道内镜检查中镇静时间具有可预测性且恢复快速；丙泊酚是临床常用的静脉麻醉药，具有起效快、作用时间短、恢复快等优点。到目前为止，比较两种药物用于全身麻醉诱导的文献较少。因此，本研究进行一项随机试验，评估瑞马唑仑在全麻诱导期间的有效性和安全性是否优于丙泊酚。

方法

将ASA I、II级行择期手术的189例患者分为四组：瑞马唑仑0.2mg/kg（R1组）、0.3mg/kg（R2组）、0.4mg/kg（R3组）、丙泊酚组（P组）；所有患者在诱导期间均采用单次注射实验药物实施麻醉，通过无补救镇静的麻醉诱导来衡量疗效，通过无严重不良事件发生衡量安全性。

结果

瑞马唑仑组诱导成功率分别为89%（R1组）、94%（R2组）和100%（R3组），P组诱导成功率为100%。与R1组（13%）和R2组（24%）相比，全麻诱导期间低血压发生率低于P组（44%）；R3组（34%）与P组（44%）麻醉诱导期间低血压发生率相似。P 组注射部位疼痛发生率为27%，瑞马唑仑组未观察到明显注射部位疼痛。

结论

瑞马唑仑是一种安全有效的镇静药物，在ASA I、II级患者麻醉诱导过程中不良反应较小。

原始文献来源

Dai G, Pei L, Duan F,et al. Safety and efficacy of remimazolam compared with propofol in induction of general Anesthesia[J]. Minerva Anestesiol. 2021 Jul 14.DOI:10.23736/S0375-9393.21.15517-8.

Safety and efficacy of remimazolam compared with propofol in induction of general anesthesia

Abstract

Background: Remimazolam is a new ultra-short acting benzodiazepine anesthetic which has predictable sedative duration and rapid recovery in gastrointestinal endoscopy. Propofol is a commonly used intravenous anesthetic in clinical work which also has rapid action, short action time and rapid recovery. To date, there have been relatively few articles comparing the two for general anesthesia induction. So we conducted a randomized trial to evaluate whether remimazolam is superior to propofol during anesthesia induction in terms of the efficacy and safety.

Methods: One hundred and eighty nine ASA I or II patients scheduled for elective surgery were divided into four groups: remimazolam 0.2mg/kg (group R1), 0.3mg/kg(group R2), 0.4mg/kg(group R3), and propofol group(group P). All patients were anesthetized with single shot of experimental drugs during induction period. Efficacy was measured by completing the induction of anesthesia without rescue sedation and safety was defined as no severe adverse events.

Results: Success induction rates in remimazolam groups were 89%(group R1), 94%(group R2) and 100%(group R3) while success induction rate in group P was 100%. Hypotension rates during induction were lower in R1 group (13%) and R2 group (24%) compared with group P (44%). Hypotension rate in R3 group (34%) was similar to propofol (44%). Injection site pain in group P was 27% while no pain was observed in remimazolam groups.

Conclusions: Remimazolam is a safe and effective sedative drug during induction with less adverse effects for general anesthesia in ASA I or II patients.

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