Abstract
Objective:To investigate the effects of remimazolam and propofol on the quality of early postoperative recovery in patients undergoing lumbar decompression and fusion under general anesthesia.Methods:A total of 92 patients who underwent lumbar decompression and fusion under general anesthesia in Huizhou First People's Hospital from December 2023 to June 2024 were selected as the research subjects.According to the different anesthetic drugs used,they were divided into remimazolam group(45 cases)and propofol group(47 cases)by random number table method.There were 18 males and 27 females in the remimazolam group,with an age of(62.4±6.8)years old;there were 16 males and 31 females in the propofol group,with an age of(62.7±8.1)years old.In the remimazolam group,6.0 mg/kg remimazolam and 0.3 μg/kg sufentanil were intravenously injected for anesthesia induction,and 0.5-1.0 mg·kg-1·h-1 remimazolam and 0.1-0.2 μg·kg-1·min-1 remimazolam were intravenously infused for anesthesia maintenance;in the propofol group,1-2 mg/kg propofol and 0.3 μg/kg sufentanil were intravenously infused for anesthesia induction,and 4-12 mg·kg-1·h-1 propofol and 0.1-0.2 μg·kg-1·min-1 remimazolam were intravenously infused for anesthesia maintenance.The main outcome measure was the postoperative 15-item quality of recovery(QoR-15)score.Secondary outcome measures included heart rate,mean arterial pressure,and bispectral index 5 minutes before anesthesia(T0),1 minute after intubation(T1),start of surgical skin incision(T2),30 minutes after surgery(T3),end of surgery(T4),immediate extubation(T5),and leaving the postanesthesia care unit(T6),the use of vasoactive drugs during surgery,the time of awakening in the postanesthesia care unit,the time of extubation,and the Richmond Agitation and Sedation Scale(RASS)score after extubation.Results:The QoR-15 scores of the remimazolam group on the first and third days after surgery were(114.1±7.2)and(128.7±5.1),respectively,and those of the propofol group were(112.8±7.8)and(127.5±4.4),respectively.There was no significant difference between the two groups(all P>0.05).Compared with the propofol group,the heart rate in the remimazolam group increased at T1-T3,the mean arterial pressure increased at T4,and the bispectral index increased at T1-T5(all P<0.05).The use rate of vasoactive drugs during surgery in the remimazolam group was 22.2%(10/45),which was lower than that in the propofol group 51.1%(24/47)(P<0.05).The awakening time and extubation time in the remimazolam group were 15(11,18)min and 16(12,19)min,respectively,which were longer than those in the propofol group,11(8,14)min and 12(10,15)min,respectively(all P<0.05).The RASS scores in the remimazolam group at 5 and 30 min after extubation were-1(-1,0)and 0(0,0),respectively,which were lower than those in the propofol group,0(-1,1)and 0(0,0)(all P<0.05).There was no significant difference in the incidence of postoperative agitation,chills,hypoxemia,nausea and vomiting between the two groups(all P>0.05).Conclusion:Compared with propofol,remimazolam can reduce the use of vasoactive drugs in lumbar decompression and fusion,has relatively stable hemodynamics,and has a better sedation state after extubation.Although it prolongs the patient's awakening time and extubation time,it does not affect the quality of early postoperative recovery.关键词
腰椎减压融合/瑞马唑仑/丙泊酚/术后恢复Key words
lumbar decompression and fusion/remimazolam/propofol/postoperative recovery分类
医药卫生
