【罂粟摘要】宫腔镜检查手术中苯磺酸瑞玛唑仑与丙泊酚的疗效和安全性比较:单中心随机对照试验
宫腔镜检查手术中苯磺酸瑞玛唑仑与丙泊酚的疗效和安全性比较:单中心随机对照试验
贵州医科大学 高鸿教授课题组
翻译：张中伟 编辑：佟睿 审校：曹莹
苯磺酸瑞玛唑仑是一种新型苯二氮卓类药物，具有起效快、作用时间短、恢复时间短、不在组织中积累的特点。本试验目的为证实在宫腔镜检查过程中，苯磺酸瑞玛唑仑与丙泊酚相比更具有效性和安全性。
接受宫腔镜检查的患者被随机分为瑞马唑仑组（R组）和丙泊酚组（P组）。R组诱导用药剂量为0.2毫克/千克，维持剂量为1.0毫克/千克/小时。在P组中，丙泊酚诱导剂量为1.5-2.0毫克/千克，维持剂量为3.0-6.0毫克/千克/小时。在苯磺酸瑞玛唑仑或丙泊酚诱导后，使用目标浓度为1.5 ng/ml的目标控制输注系统输注瑞芬太尼，并在手术过程中使用滴定法测量。比较两组产生注射疼痛、低血氧饱和度和不良反应的发生率。
82名患者被纳入本研究。R组(3.7%)的不良事件发生率明显低于P组(36.6%) (p< 0.001)。P组(80.5%)的注射痛发生率明显高于R组(2.4%) (p< 0.001)。其他不良事件的发生率，如低血氧饱和度、心动过缓和低血压，R组低于P组(p< 0.05)。
苯磺酸瑞玛唑仑被证明是宫腔镜检查中更安全的麻醉用药选择。此外，丙泊酚引起的不良事件，如低血氧饱和度和注射疼痛，在很大程度上得以避免。
Xiaoqiang Zhang*, Shuang Li and Jing Liu. Efficacy and safety of remimazolam besylate versus propofol during hysteroscopy: single-centre randomized
controlled trial.[J].BMC Anesthesiology，(2021) 21:156 :1
Efficacy and safety of remimazolam
besylate versus propofol during
hysteroscopy: single-centre randomized
controlled trial
Background: Remimazolam besylate is a newer benzodiazepine with characteristics of quick onset of effects, short maintenance and recovery times without accumulation in tissues. This trial was conducted to confirm the efficacy and safety of remimazolam besylate versus propofol during hysteroscopy.
Methods: Patients undergoing hysteroscopy were randomly assigned to either the remimazolam (Group R) or the propofol group (Group P). Group R was administered an induction dose of 0.2 mg/kg and a maintenance dosage of 1.0 mg/kg/h. In Group P, propofol was started at 1.5–2.0 mg/kg and then maintained at 3.0–6.0 mg/kg/h. After remimazolam besylate or propofol induction, remifentanil was infused using a target-controlled infusion system with a target concentration of 1.5 ng/ml and titrated during the procedure. The incidence rates of injection pain,low oxygen saturation (SpO2) and adverse effects in both groups were compared.
Results: Eighty-two patients were included in this study. The incidence of adverse events in Group R (3.7%) was significantly lower than that in Group P (36.6%) (p< 0.001). The incidence of injection pain in Group P (80.5%) was
much higher than that in Group R (2.4%) (p< 0.001). The incidence of other adverse events, such as low SpO2,bradycardia, and hypotension in Group R was lower than that in Group P (p< 0.05).
Conclusions: Remimazolam besylate proves to be a safer alternative for anesthesia during hysteroscopy. Moreover,adverse events caused by propofol, such as low SpO2and injection pain, are largely avoided.