中国临床药理学杂志2025，Vol.41Issue(14)：1963-1968,6.DOI:10.13699/j.cnki.1001-6821.2025.14.003
瑞马唑仑与右美托咪定在全身麻醉下行俯卧位脊柱手术患者的临床研究
Clinical trial of remimazolam versus dexmedetomidine in patients undergoing prone position spinal surgery under general anesthesia
摘要
Abstract
Objective To observe the clinical efficacy and safety of remimazolam injection versus dexmedetomidine injection in patients undergoing prone position spinal surgery under general anesthesia.Methods Patients scheduled for selective prone position spinal surgery were included and randomly divided into treatment group and control group.Treatment group received an intravenous injection of remimazolam 0.2 mg·kg-1 before anesthesia induction,followed by a continuous infusion of 0.1 mg·kg-1·h-1 intraoperatively.The control group received an intravenous infusion of dexmedetomidine over 10 minutes before anesthesia induction,followed by a continuous infusion of 0.4 μg·kg-1·h-1 intraoperatively.The general surgical conditions,intraoperative hemodynamics,visual analogue scale(VAS)scores for pain at 30 min,6 h and 24 h post-awakening,use of patient-controlled intravenous analgesia(PCIA)and rescue analgesia,preoperative and postoperative stress indicators the incidence of postoperative delirium and adverse drug reactions were compared between the two groups.Results A total of 108 cases were screened,and 98 cases were enrolled.7 cases fell out due to incomplete data recording and adjustment of anesthesia scheme.Finally,there were 45 cases in treatment group and 46 cases in control group.The postoperative awakening time in treatment group and the control group were(10.28±2.13)and(15.72±3.34)min,respectively;at the time of intubation(T1),the mean arterial pressure(MAP)in the treatment and control groups was(87.64±7.12)and(92.42±6.53)mmHg,respectively,the heart rate(HR)were(82.72±9.23)and(88.53±8.73)beats·min-1,respectively;at the time of skin incision(T2),the MAP were(86.24±6.83)and(90.31±7.21)mmHg,respectively.The differences between the two groups were statistically significant different(all P＜0.05);the VAS scores for pain at 30 min and 6 h post-awakening in the experimental group were(4.56±0.97)and(3.42±0.71)scores,respectively,compared to(5.25±1.12)and(3.89±0.85)scores in the control group,with statistically significant differences(both P＜0.05).The time to first PCIA request,number of PCIA demands and number of rescue analgesia administrations in the treatment group were(3.24±0.73)h,(12.73±2.95)times and(1.23±0.58)times,respectively,compared to(2.51±0.67)h,(15.14±3.28)times and(1.82±0.76)times in the control group,with statistically significant differences(all P＜0.05).At 24 h postoperatively,the plasma cortisol and epinephrine concentrations in the treatment group were(402.63±67.20)nmol·L-1 and(0.28±0.09)ng·mL-1,respectively,compared to(478.92±73.53)nmol·L-1 and(0.41±0.12)ng·mL-1 in the control group,with statistically significant differences(both P＜0.05).The incidence of postoperative delirium within 72 h was 4.44％in the treatment group and 6.52％in control group,with no statistically significant difference(P＞0.05).The main adverse drug reactions in both groups were respiratory depression,hypotension,bradycardia,nausea and vomiting,dizziness and headache and somnolence.There were no statistically significant differences in the incidence rates of these adverse reactions between the two groups(all P＞0.05).Conclusion Compared with dexmedetomidine,remimazolam during elective spinal surgery in prone position under general anesthesia has shorter recovery time,more stable intraoperative hemodynamics and better analgesic effect.It is more helpful to relieve the postoperative stress response and does not increase the incidence rates of adverse drug reactions.关键词
瑞马唑仑注射液/右美托咪定注射液/脊柱手术/全身麻醉/麻醉效果/血流动力学Key words
remimazolam/dexmedetomidine/spinal surgery/general anesthesia/anesthetic effect/hemodynamics分类
医药卫生引用本文复制引用
崔晶,周宝龙,齐新宇,姚兰..瑞马唑仑与右美托咪定在全身麻醉下行俯卧位脊柱手术患者的临床研究[J].中国临床药理学杂志,2025,41(14):1963-1968,6.基金项目
湖北陈考平科技发展基金会青年科学专项基金资助项目(CXPJJH123001-2324) （CXPJJH123001-2324）
