哈尔滨医药2025，Vol.45Issue(2)：11-14,4.DOI:10.3969/j.issn.1001-8131.2025.02.004
不同诱导剂量甲苯磺酸瑞马唑仑在急性胆囊炎患者腹腔镜手术全麻诱导中的应用对比
Comparison of the Application of Different Induction Doses of Remimazolam Tosilate in the Induction of General Anesthesia for Patients with Acute Cholecystitis undergoing Laparoscopic Surgery
摘要
Abstract
Objective To investigate the efficacy and safety of different induction doses of remimazolam tosilate for general anesthesia in patients with acute cholecystitis undergoing laparoscopic surgery.Methods A total of 93 patients scheduled for laparoscopic surgery were randomly allocated into three groups(R1,R2,and R3),each comprising 31 patients.Anesthesia was induced with intravenous remimazolam tosilate at doses of 0.20 mg/kg,0.25 mg/kg,and 0.30 mg/kg over 30 seconds,respectively,followed by sufentanil 0.4 μg/kg and rocuronium 0.6 mg/kg for endotracheal intubation.Anesthesia maintenance was achieved using a continuous infusion of remimazolam tosilate at 0.5 mg/(kg·h),remifentanil at 6-12 μg/(kg·h),and sevoflurane at 1%.The effectiveness of sedation,hemodynamic parameters,stress response indices,anesthetic drug consumption,patient recovery status,and incidence of adverse events during anesthesia induction were recorded and compared among the groups.Results The time to loss of eyelash reflex and onset of sedation were significantly shorter in group R3 compared to groups R1 and R2,and in group R2 compared to group R1(P<0.05).There were no significant differences in heart rate(HR)and mean arterial pressure(MAP)before anesthesia(T0),at tracheal intubation(T1),5 minutes post-induction(T2),and at the end of surgery(T3)across the groups(P>0.05).Serum concentrations of norepinephrine(NE)and cortisol(Cor)were lower in group R3 than in groups R1 and R2 at the end of surgery and 6 hours postoperatively(P<0.05).Additionally,the intraoperative doses of sufentanil and remifentanil were significantly lower in group R3 compared to groups R1 and R2(P<0.05).No significant differences were observed in recovery times or overall incidence of adverse reactions between the groups(P>0.05).Conclusion Both 0.25 mg/kg and 0.30 mg/kg remimazolam tosilate are safe and effective for inducing general anesthesia in patients with acute cholecystitis undergoing laparoscopic surgery.However,the 0.30 mg/kg dose offers advantages by shortening the onset time of sedation,reducing intraoperative anesthetic requirements,and mitigating the stress response,making it a preferable option.关键词
全身麻醉/麻醉诱导/甲苯磺酸瑞马唑仑/急性胆囊炎/腹腔镜手术Key words
General anesthesia/Anesthesia induction/Remimazolam tosilate/Acute cholecystitis/Laparoscopic surgery分类
医药卫生引用本文复制引用
张艳霞,尚美娟,许少华..不同诱导剂量甲苯磺酸瑞马唑仑在急性胆囊炎患者腹腔镜手术全麻诱导中的应用对比[J].哈尔滨医药,2025,45(2):11-14,4.基金项目
河南省联合共建项目(LHGJ20210043) （LHGJ20210043）
