不同诱导剂量甲苯磺酸瑞马唑仑在急性胆囊炎患者腹腔镜手术全麻诱导中的应用对比

doi:10.3969/j.issn.1001-8131.2025.02.004

Abstract
Figure/Table
References
Related Citation (15)

Download: PDF (523 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the efficacy and safety of different induction doses of remimazolam tosilate for general anesthesia in patients with acute cholecystitis undergoing laparoscopic surgery.Methods A total of 93 patients scheduled for laparoscopic surgery were randomly allocated into three groups（R1,R2,and R3）,each comprising 31 patients.Anesthesia was induced with intravenous remimazolam tosilate at doses of 0.20 mg/kg,0.25 mg/kg,and 0.30 mg/kg over 30 seconds,respectively,followed by sufentanil 0.4 μg/kg and rocuronium 0.6 mg/kg for endotracheal intubation.Anesthesia maintenance was achieved using a continuous infusion of remimazolam tosilate at 0.5 mg/（kg·h）,remifentanil at 6-12 μg/（kg·h）,and sevoflurane at 1%.The effectiveness of sedation,hemodynamic parameters,stress response indices,anesthetic drug consumption,patient recovery status,and incidence of adverse events during anesthesia induction were recorded and compared among the groups.Results The time to loss of eyelash reflex and onset of sedation were significantly shorter in group R3 compared to groups R1 and R2,and in group R2 compared to group R1（P<0.05）.There were no significant differences in heart rate（HR）and mean arterial pressure（MAP）before anesthesia（T0）,at tracheal intubation（T1）,5 minutes post-induction（T2）,and at the end of surgery（T3）across the groups（P>0.05）.Serum concentrations of norepinephrine（NE）and cortisol（Cor）were lower in group R3 than in groups R1 and R2 at the end of surgery and 6 hours postoperatively（P<0.05）.Additionally,the intraoperative doses of sufentanil and remifentanil were significantly lower in group R3 compared to groups R1 and R2（P<0.05）.No significant differences were observed in recovery times or overall incidence of adverse reactions between the groups（P>0.05）.Conclusion Both 0.25 mg/kg and 0.30 mg/kg remimazolam tosilate are safe and effective for inducing general anesthesia in patients with acute cholecystitis undergoing laparoscopic surgery.However,the 0.30 mg/kg dose offers advantages by shortening the onset time of sedation,reducing intraoperative anesthetic requirements,and mitigating the stress response,making it a preferable option.

Key words： General anesthesia Anesthesia induction Remimazolam tosilate Acute cholecystitis Laparoscopic surgery

Received: 15 February 2025

PACS:

R971+.2

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Zhang Yanxia
	Shang Meijuan
	Xu Shaohua

Cite this article:

Zhang Yanxia,Shang Meijuan,Xu Shaohua. Comparison of the Application of Different Induction Doses of Remimazolam Tosilate in the Induction of General Anesthesia for Patients with Acute Cholecystitis undergoing Laparoscopic Surgery[J]. journal1, 2025, 45(2): 11-14.

URL:

http://www.hrbyybjb.org.cn/EN/10.3969/j.issn.1001-8131.2025.02.004 OR http://www.hrbyybjb.org.cn/EN/Y2025/V45/I2/11

[1] Costanzo ML,D'Andrea V,Lauro A,et al.Acute Chole-cystitis from Biliary Lithiasis:Diagnosis,Management and Treatment[J].Antibiotics,2023,12(3):482.
[2] Yu JM,Tao QY,He Y,et al.Opioid-Free Anesthesia for Pain Relief After Laparoscopic Cholecystectomy:A Prospective Randomized Controlled Trial[J].J Pain Res,2023,16(1):3625-3632.
[3] 孙瑞玥,刘雅琴,黄巾.甲苯磺酸瑞马唑仑和咪达唑仑对重症患者行纤维支气管镜检查时心率和血压的影响[J].感染、炎症、修复,2023,24(1):32-34.
[4] 赵晓咏,夏瑞,刘香玉,等.瑞马唑仑用于腹部手术患者全麻诱导与维持的效果[J].中华麻醉学杂志,2021,41(7):823-826.
[5] Uzuki Y,Doi M,Nakajima Y.General anesthesia with remimazolam in a patient with mitochondrial enceph-alomyopathy:a case report[J].JA Clin Rep,2021,7(1):51.
[6] 陈瑜,蔡姝,朱晓刚,等.瑞马唑仑用于老年患者全麻诱导时的镇静效果[J].中华麻醉学杂志,2020,40(8):974-976.
[7] 中华医学会外科学分会胆道外科学组.急性胆道系统感染的诊断和治疗指南(2021版)[J].中华外科杂志,2021,59(6):422-429.
[8] 白雪,罗昊,黄雅莹,等.甲苯磺酸瑞马唑仑与丙泊酚在儿童无痛胃镜检查中的比较[J].实用医学杂志,2023,39(19):2529-2533.
[9] 姜倩,王晓芳.甲苯磺酸瑞马唑仑与丙泊酚在经皮腔内血管成形术治疗老年下肢动脉硬化闭塞症中的应用效果[J].中国老年学杂志,2022,42(16):3962-3964.
[10] So KY,Park J,Kim SH.Safety and efficacy of remimazolam for general anesthesia in elderly patients undergoing laparoscopic cholecystectomy:a randomized controlled trial[J].Front Med,2023,10(1):1265860.
[11] 瑞马唑仑临床应用专家指导意见专家组.瑞马唑仑临床应用专家指导意见[J].国际麻醉学与复苏杂志,2023,44(6):561-566.
[12] 郑文壮,王军,王刚,等.右美托咪定联合纳布啡对腹腔镜胆囊切除术患者全身麻醉苏醒期血流动力学和躁动的影响[J].中国内镜杂志,2022,28(4):55-61.
[13] Dai G,Pei L,Duan F,et al.Safety and efficacy of remimazolam compared with propofol in induction of general anesthesia[J].Minerva Anestesiol,2021,87(10):1073-1079.
[14] Hu Q,Liu X,Wen C,et al.Remimazolam:An Updated Review of a New Sedative and Anaesthetic[J].Drug Des Devel Ther,2022,16(1):3957-3974.
[15] 魏来,李洁琼,洪谭浩,等.不同剂量瑞马唑仑用于宫腔镜手术的安全性和有效性[J].临床麻醉学杂志,2022,38(4):346-350.