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| 瑞马唑仑对患儿口腔日间手术苏醒期躁动的影响 |
| Effects of remimazolam on emergence agitation in children undergoing oral day surgery |
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| DOI：10.12089/jca.2025.01.010 |
| 中文关键词: 丙泊酚 瑞马唑仑 苏醒期躁动 日间手术 |
| 英文关键词: Propofol Remimazolam Emergence agitation Day surgery |
| 基金项目:国家自然科学基金（81801380） |
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| 中文摘要: |
目的：探讨瑞马唑仑对患儿口腔日间手术苏醒期躁动的影响。
方法：选择全麻下行龋齿治疗的患儿62例，男33例，女29例，年龄3～6岁，BMI 12～23 kg/m2，ASA Ⅰ或Ⅱ级。将患儿随机分为两组：瑞马唑仑组和丙泊酚组，每组31例。瑞马唑仑组麻醉诱导时静脉推注瑞马唑仑0.3 mg/kg，麻醉维持时泵注瑞马唑仑1 mg·kg-1·h-1；丙泊酚组麻醉诱导时静脉推注丙泊酚2 mg/kg，麻醉维持时泵注丙泊酚6 mg·kg-1·h-1。记录拔管即刻、拔管后30 min及拔管后2 h患儿苏醒期躁动（PAED）评分、Ramsay镇静评分和患儿行为学（FLACC）疼痛评分。记录麻醉时间、手术时间、术中输液量、出血量、苏醒时间及阿芬太尼总量。记录恶心呕吐、低氧血症、喉痉挛、嗜睡、苏醒期躁动等不良事件的发生情况。
结果： 与丙泊酚组比较，瑞马唑仑组拔管后30 min PAED评分明显降低（P<0.05），Ramsay镇静评分明显升高（P<0.05），苏醒期躁动发生率明显降低（P<0.05）。两组恶心呕吐、低氧血症、喉痉挛及嗜睡不良事件发生率差异无统计学意义。
结论：与丙泊酚比较，采用瑞马唑仑可降低口腔日间手术患儿苏醒期躁动发生率，且不增加围术期不良事件。 |
| 英文摘要: |
Objective: To explore the effects of remimazolam combined with sevoflurane on emergence agitation in children undergoing oral day surgery.
Methods: Sixty-two children with dental caries were selected for treatment under general anesthesia, including 33 males and 29 females, aged 3-6 years, BMI 12-23 kg/m2, and ASA physical status Ⅰ or Ⅱ. Patients were randomly divided into two groups: remimazolam group and propofol group, 31 patiens in each group. Remimazolam group received intravenous injection of remimazolam at 0.3 mg/kg during induction, and it was administered at rate of 1 mg·kg-1·h-1 during maintenance. Propofol group received intravenous injection of propofol 2 mg/kg during induction, and it was administered at a rate of 6 mg·kg-1·h-1 during maintenance. The pediatric anesthesia emergence delirium (PAED) score, Ramsay sedation score and face, legs, activity, cry, consolability (FLACC) behavioral pain score of the children were recorded immediately, 30 minutes and 2 hours after extubation. The anesthesia time, operation time, intraoperative fluid infusion volume, blood loss, recovery time, and total amount of alfentanil were recorded. The incidence of nausea and vomiting, hypoxemia, laryngospasm, drowsiness and emergence agitation were also recorded.
Results: Compared with propofol group, PAED score was significantly decreased (P < 0.05), and Ramsay sedation score was significantly increased 30 minutes after extubation (P < 0.05), and incidence rate of emergence agitation was significantly decreased in remimazolam group (P < 0.05). There was no significant difference in the incidence of nausea and vomiting, hypoxemia, laryngospasm, and drowsiness between the two groups.
Conclusion: Compared with propofol, remimazolam combined with sevoflurane can significantly reduce the incidence of emergence agitation in children undergoing day oral surgery, and does not increase the incidence of other perioperative adverse events. |
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