右江医学2025，Vol.53Issue(7)：607-614,8.DOI:10.3969/j.issn.1003-1383.2025.07.005
甲苯磺酸瑞马唑仑联合瑞芬太尼用于ICU气管插管患者的镇静效果和安全性分析
Analysis of sedation effect and safety of rimazolam tosylate combined with remifentanil in patients with tracheal intubation in ICU
摘要
Abstract
Objective To analyze the sedative effect and safety of rimazolam tosylate combined with remifentanil in ICU patients undergoing tracheal intubation.Methods A total of 100 patients who were admitted to the ICU of the Fifth Affilia-ted Hospital of Zhengzhou University and underwent tracheal intubation from January 2023 to February 2024 were selected.According to random number table,the patients were divided into propofol group(group P)and rimazolam tosylate group(group R),with 50 patients in each group.Both groups were combined with remifentanil(administered as an intravenous bolus of 0.5 μg/kg,followed by a maintenance infusion of 4-9 μg·kg-1·min-1).The positive responses to tracheal intubation were recorded for both groups of patients,and the time required to reach the sedation target and the modified observer's assessment of alertness/sedation(MOAA/S)sedation score at 2 minutes after drug administration were also recor-ded for both groups.The cardiovascular and respiratory parameters(heart rate[HR],mean arterial pressure[MAP],respiratory rate[RR],and arterial oxygen saturation[SpO2])were recorded at the following time points:before anesthesia(T0),at the time of loss of consciousness(T1),immediately before intubation(T2),3 min after intubation(T3),10 min after intubation(T4),30 min after intubation(T5),1 h after intubation(T6),and 2 h after intubation(T7).The dura-tion of mechanical ventilation,ICU length of stay,total hospitalization time,and ICU mortality rate were recorded for both groups of patients.In addition,the incidence of adverse reactions was counted.Results There was no statistically signifi-cant difference in the positive responses to tracheal intubation between the two groups of patients(P＞0.05).Additionally,there was no statistically significant difference in the time required to reach the sedation target or MOAA/S sedation scores at 2 min after drug administration between the two groups(P＞0.05).From T1 to T6,the HR and RR in the group R were higher than those in the group P,and difference was statistically significant(P＜0.05).From T1 to T5,the MAP in the group R was higher than that in the group P,and difference was statistically significant(P＜0.05).At T2 and T3,the SpO2 in the group R was higher than that in the group P,and difference was statistically significant(P＜0.05).Compared with the group P,the duration of mechanical ventilation and the length of stay in the ICU were significantly shorter in the group R af-ter drug administration,and difference was statistically significant(P＜0.05).The incidence of bradycardia,hypotension,and respiratory depression in the group R was significantly lower,so difference was statistically significant(P＜0.05).Conclusion Remimazolam tosilate combined with remifentanil for sedation in ICU patients undergoing tracheal intubation can effectively suppress strong stress responses while ensuring sedative efficacy.It has minimal impact on the cardiovascular and respiratory systems,reduces the duration of mechanical ventilation and ICU length of stay,with a lower incidence of adverse reactions and greater safety.关键词
甲苯磺酸瑞马唑仑/气管插管/瑞芬太尼/镇静/不良反应Key words
remimazolam tosilate/tracheal intubation/remifentanil/sedation/adverse reaction分类
医药卫生引用本文复制引用
原雪芳,冯永海..甲苯磺酸瑞马唑仑联合瑞芬太尼用于ICU气管插管患者的镇静效果和安全性分析[J].右江医学,2025,53(7):607-614,8.基金项目
中国红十字基金会医学赋能公益专项基金"医学赋能与人才培养计划"科研项目(CRCF-YXFN-202201149) （CRCF-YXFN-202201149）
