Abstract:

Objective　To compare the effects of remazolam and propofol in the induction and maintenance of general anesthesia for patients undergoing non-glaucoma eye surgery. Methods　Seventy-five patients taking non-glaucoma ophthalmic surgery at Eye Hospital Affiliated to Shandong University of Traditional Chinese Medicine from January to December 2022 were divided into a control group (37 cases) and an observation group (38 cases) according to the odd and even hospitalization numbers. There were 20 men and 17 women in the control group; they were (50.51±3.78) years old. There were 21 men and 17 women in the observation group; they were (50.55±3.76) years old. The control group took general anesthesia by propofol laryngeal masks, and the observation group by remazolam laryngeal masks. The hemodynamics, anesthesia and emergence, Riker sedation-agitation scores, and adverse reactions were compared between the two groups. t and χ² tests were used to analyzed the data. Results　The mean arterial pressures (MAP) after laryngeal mask placement, before surgery, and at drug withdrawal in both groups (mean artery pressure,) were lower than those before anesthesia induction; the MAP's before surgery and at drug withdrawal in the observation group were higher than those in the control group [(87.57±9.65) mmHg (1 mmHg=0.133 kPa) vs. (82.54±9.84) mmHg and (87.78±9.55) mmHg vs. (81.10±9.68) mmHg; t=2.235 and 3.008; P=0.028 and 0.004]. The heart rates (HR) before surgery and at drug withdrawal in both groups were lower than those before the induction of anesthesia; the HR's before surgery and at drug withdrawal in the observation group were higher than those in the control group [(76.17±9.67) beats/min vs. (71.40±9.77) beats/min and (76.55±10.45) beats/min vs. (70.08±10.76) beats/min; t=2.125 and 2.642; P=0.037 and 0.010]. The disappearance time of eyelash reflex in the observation group was longer than that in the control group [(45.16±10.27) s vs. (33.69±7.54) s; t=5.501, P<0.001]. The intraoperative body movements in the observation group was fewer than that in the control group [(1.02±0.22) times vs. (1.48±0.25) times; t=-8.465, P<0.001]. The Riker sedative-agitation scores 1 and 10 min after tube withdrawal in the observation group were lower than those in the control group [(3.31±1.04) vs. (3.95±1.10) and (3.35±0.92) vs. (3.91±0.95); t=-2.590 and -2.593; P=0.012 and 0.011]. The overall incidences of agitation, nausea and vomiting, delusion, hypoxemia, and blood pressure decline in the observation group and the control group were 10.53% (4/38) and 16.22% (6/37), respectively, with no statistical difference (χ²=0.525, P=0.469). Conclusions　Remazolam can be effectively used for inducing and maintaining laryngeal mask anesthesia in patients taking non-glaucoma ophthalmic surgery. Compared with those in the patients taking propofol anesthesia, the hemodynamics of the patients taking remmazolam anesthesia is more stable and the sedative effect is better.

Key words:

Ophthalmology department, Remmazolam, Propofol, Laryngeal mask general anesthesia induction, Hemodynamics

摘要：

目的　比较瑞马唑仑与丙泊酚在非青光眼眼科手术患者喉罩全麻诱导、维持中的应用效果。方法　前瞻性选取2022年1月至12月山东中医药大学附属眼科医院收治的75例行非青光眼眼科手术患者，依据住院号奇偶数法分为对照组（37例）和观察组（38例）。对照组男20例，女17例，年龄（50.51±3.78）岁，采用丙泊酚喉罩全麻；观察组男21例，女17例，年龄（50.55±3.76）岁，采用瑞马唑仑喉罩全麻。比较两组患者的血流动力学、麻醉与苏醒情况、Riker镇静-躁动评分及不良反应发生情况。采用t检验、χ²检验进行数据分析。结果　两组喉罩置入后、手术前及停药时平均动脉压（MAP）比麻醉诱导前降低，且观察组手术前MAP［（87.57±9.65）mmHg（1 mmHg=0.133 kPa）］、停药时MAP［（87.78±9.55）mmHg］均高于对照组［（82.54±9.84）mmHg、（81.10±9.68）mmHg］（t=2.235，P=0.028；t=3.008，P=0.004）；两组手术前、停药时心率（HR）比麻醉诱导前下降，且观察组手术前HR［（76.17±9.67）次/min］、停药时HR［（76.55±10.45）次/min］均高于对照组患者［（71.40±9.77）次/min、（70.08±10.76）次/min］（t=2.125，P=0.037；t=2.642，P=0.010）；观察组睫毛反射消失时间为（45.16±10.27）s，较对照组（33.69±7.54）s长（t=5.501，P<0.001），观察组术中体动数为（1.02±0.22）次，较对照组（1.48±0.25）次少（t=-8.465，P<0.001）；观察组拔管后1、10 min Riker镇静-躁动评分［（3.31±1.04）分、（3.35±0.92）分］均低于对照组［（3.95±1.10）分、（3.91±0.95）分］（t=-2.590，P=0.012；t=-2.593，P=0.011）；观察组躁动、恶心呕吐、谵妄、低氧血症及血压下降不良反应总发生率为10.53%（4/38），对照组为16.22%（6/37），差异无统计学意义（χ²=0.525，P=0.469）。结论　瑞马唑仑可有效用于非青光眼眼科手术患者喉罩全麻诱导、维持，与使用丙泊酚麻醉相比，患者血流动力学更稳定，镇静效果更好。

关键词:

眼科, 瑞马唑仑, 丙泊酚, 喉罩全麻诱导, 血流动力学