瑞马唑仑与丙泊酚用于全身麻醉诱导中安全性和有效性的比较

瑞马唑仑与丙泊酚用于全身麻醉诱导中安全性和有效性的比较

贵州医科大学     麻醉与心脏电生理课题组

翻译：吴学艳  编辑：陈锐  审核：曹莹

罂 粟 摘 要 

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具有镇静持续时间可预测、恢复快等优点；丙泊酚是临床上常用的静脉麻醉药，具有起效快、作用时间短、恢复快等优点。目前为止，比较两者在全身麻醉诱导中的研究较少；因此，我们进行此项随机试验，拟评价瑞马唑仑在麻醉诱导期间的有效性和安全性是否优于丙泊酚。

方法：研究共纳入189例行择期手术患者，随机分为4组：瑞咪唑仑0.2mg/kg(R1组)、0.3mg/kg(R2组)、0.4mg/kg(R3组)和丙泊酚组(P组)；麻醉诱导期，所有患者均采用单次注射实验药物麻醉；通过完成麻醉诱导而无需追加补救性镇静药物来衡量有效性，安全性定义为无严重不良事件。

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%；诱导期低血压发生率R1组(13%)、R2组(24%)均低于P组(44%)；R3组低血压发生率(34%)与丙泊酚组(44%)相似。P组注射部位疼痛发生率为27%，瑞咪唑仑组无注射痛。

结论：瑞马唑仑是一种安全有效的镇静药物，用于ASAI、II级患者全麻诱导期间不良反应较少。

原始文献来源： 

Dai G, Pei L, Duan F, Liao M, Zhang Y, Zhu M, et al. Safety and efficacy of remimazolam compared with propofol in induction of general anesthesia. Minerva Anestesiol 2021;87:1073-9. DOI: 10.23736/S0375-9393.21.15517-8)

英文原文  l  

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

Abstract

Background: Remimazolam is a new ultrashort 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 efficacy and safety.

Methods: One hundred and eighty nine ASA I or II patients scheduled for elective surgery were divided into four groups: remimazolam 0.2 mg/kg (R1 group), 0.3 mg/kg (R2 group), 0.4 mg/kg (R3 group), and propofol group (P group). All patients were anesthetized with single shots 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% (R1 group), 94% (R2 group) and 100% (R3 group) while success induction rate in P group was 100%. Hypotension rates during induction were lower in R1 group (13%) and R2 group (24%) compared with P group (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.