天津医药

天津医药 ›› 2025, Vol. 53 ›› Issue (4): 425-428.doi: 10.11958/20250308

• 药物临床观察 • 上一篇    下一篇

瑞马唑仑对全麻下斜视手术患儿苏醒质量的影响

缪妍1(), 朱蕾1, 樊元慧2   

  1. 1 保定市第一中心医院麻醉科（邮编071000）
    2 手术室
  • 收稿日期:2025-01-17 修回日期:2025-02-18 出版日期:2025-04-15 发布日期:2025-04-17
  • 作者简介:缪妍（1989），女，副主任医师，主要从事麻醉方面研究。E-mail：humh133jy@163.com
  • 基金资助:
    保定市科技计划项目(2041ZF093)

Effect of remimazolam on recovery quality of children with strabismus surgery under general anesthesia

MIAO Yan1(), ZHU Lei1, FAN Yuanhui2   

  1. 1 Department of Anesthesiology
    2 Department of Operation Room, the First Central Hospital of Baoding, Baoding 071000, China
  • Received:2025-01-17 Revised:2025-02-18 Published:2025-04-15 Online:2025-04-17

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摘要：

目的 比较瑞马唑仑与丙泊酚对全麻下斜视手术患儿苏醒质量的影响。方法 纳入拟行斜视手术的患儿100例，依照随机数字表法纳入瑞马唑仑组（R组）或丙泊酚组（P组）。R组患儿静脉注射瑞马唑仑0.2 mg/kg，泵注瑞马唑仑1~3 mg·kg-1·h-1；P组患儿静脉注射丙泊酚2.5 mg/kg，泵注丙泊酚4~12 mg·kg-1·h-1。记录术中低血压、拔管时间、麻醉后监测治疗室（PACU）停留时间以及术后恶心呕吐（PONV）、苏醒期躁动发生情况。采用小儿麻醉苏醒期谵妄量表（PAED）评分评价患儿苏醒期躁动情况。结果 最终R、P组分别纳入49、50例患儿。与P组比较，R组麻醉诱导后、手术开始后15 min平均动脉压、心率升高（P<0.05），R组术中低血压发生率（14.3% vs. 46.0%）、苏醒期躁动发生率（14.3% vs. 38.0%）明显低于P组（P<0.05）。R组拔管时间[（15.7±5.8）min vs. （11.3±4.6）min]、PACU停留时间[（27.5±7.3））min vs. （23.2±6.5）min]明显长于P组，而最高PAED评分[（7.6±2.9）分 vs. （9.4±3.3）分]明显低于P组（P<0.05）。结论 与丙泊酚相比，瑞马唑仑能够降低全麻下斜视手术患儿苏醒期躁动风险，并且在维持术中血流动力学稳定方面具有优势。

关键词: 苯二氮?类, 斜视, 苏醒谵妄, 血流动力学, 二异丙酚, 儿童, 瑞马唑仑

Abstract:

Objective To compare the effects of remimazolam and propofol on the quality of recovery in children with strabismus surgery under general anesthesia. Methods A total of 100 children scheduled for strabismus surgery were enrolled and randomly assigned to the remimazolam group (R group) or the propofol group (P group). Children in the R group received intravenous remimazolam 0.2 mg/kg, followed by remimazolam infusion at a rate of 1-3 mg·kg-1·h-1. Children in the P group received intravenous propofol 2.5 mg/kg, followed by propofol infusion at a rate of 4-12 mg·kg-1·h-1. The intraoperative hypotension, extubation time, post-anesthesia care unit (PACU) stay time, postoperative nausea and vomiting (PONV), and incidence of emergence agitation were recorded in the two groups of patients. Emergence agitation was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale. Results A total of 49 and 50 children were included in the R group and the P group, respectively. Compared with the P group, the R group showed a significant increase in mean arterial pressure and heart rate at 15 minutes after the start of surgery (P < 0.05). The incidence of intraoperative hypotension (14.3% vs. 46.0%) and emergence agitation (14.3% vs. 38.0%) were significantly lower in the R group than those in the P group (P < 0.05). The extubation time [(15.7±5.8) min vs. (11.3±4.6) min], PACU stay time [(27.5±7.3) min vs. (23.2±6.5) min] were significantly longer in the R group than those in the P group, while the highest PAED score [(7.6±2.9) vs. (9.4±3.3)] was significantly lower in the R group than that in the P group, (P < 0.05). Conclusion Compared with propofol, remimazolam can reduce the risk of emergence agitation in children undergoing strabismus surgery under general anesthesia, and has advantages in maintaining hemodynamic stability during surgery.

Key words: benzodiazepines, strabismus, emergence delirium, hemodynamics, propofol, child, remimazolam

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