[1]马鸣敏,王 仁,王洪明,等.瑞马唑仑联合舒芬太尼在功能性鼻内镜鼻窦手术治疗慢性鼻窦炎伴鼻息肉中的临床价值研究[J].陕西医学杂志,2025,54(5):669-673.[doi:DOI:10.3969/j.issn.1000-7377.2025.05.019]
　MA Mingmin,WANG Ren,WANG Hongming,et al.Value of remimazolam combined with sufentanil in functional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps[J].,2025,54(5):669-673.[doi:DOI:10.3969/j.issn.1000-7377.2025.05.019]
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瑞马唑仑联合舒芬太尼在功能性鼻内镜鼻窦手术治疗慢性鼻窦炎伴鼻息肉中的临床价值研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年5期
页码:
669-673
栏目:
药物与临床
出版日期:
2025-05-05

文章信息/Info

Title:
Value of remimazolam combined with sufentanil in functional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps
作者:
马鸣敏; 王 仁; 王洪明; 朱平平; 崔贝贝
(洛阳市第一人民医院,河南 洛阳 471000)
Author(s):
MA Mingmin; WANG Ren; WANG Hongming; ZHU Pingping; CUI Beibei
(Luoyang First People's Hospital,Luoyang 471000,China)
关键词:
慢性鼻窦炎伴鼻息肉;  瑞马唑仑;  舒芬太尼;  功能性鼻内镜鼻窦手术;  苏醒时间;  血流动力学
Keywords:
Chronic rhinosinusitis with nasal polyps;  Remimazolam;  Sufentanil;  Functional endoscopic sinus surgery;  Awakening time;  Hemodynamics
分类号:
R 765.41
DOI:
DOI:10.3969/j.issn.1000-7377.2025.05.019
文献标志码:
A
摘要:
目的:探讨瑞马唑仑联合舒芬太尼在功能性鼻内镜鼻窦手术(FESS)治疗慢性鼻窦炎伴鼻息肉中的临床价值。方法:选取82例拟行FESS的慢性鼻窦炎伴鼻息肉患者,随机分为对照组(给予丙泊酚联合舒芬太尼麻醉)和研究组(给予瑞马唑仑联合舒芬太尼麻醉),各41例。记录并比较两组术后2、6、12、24 h视觉模拟评分法(VAS)评分、Ramsay镇静评分; 比较两组麻醉前(T0)、插管时(T1)、入内镜时(T2)、切除息肉时(T3)、拔管后10 min(T4)心率、收缩压、舒张压、平均动脉压; 比较两组术前、术后2、12、24、48 h血清去甲肾上腺素(Ne)、皮质醇(Cor)、过氧化氢酶(CAT)水平; 比较两组离室时间、自主呼吸恢复时间、麻醉起效时间、苏醒时间以及术后不良反应发生情况。结果:研究组术后2、6、12 h VAS评分低于对照组,Ramsay镇静评分高于对照组(均P<0.05)。研究组T1、T2、T3时刻心率高于对照组,收缩压、舒张压、平均动脉压低于对照组(均P<0.05)。研究组术后2、12、24、48 h血清Cor、Ne、CAT水平低于对照组(均P<0.05)。研究组麻醉起效时间长于对照组,苏醒时间短于对照组(均P<0.05)。两组术后不良反应发生率比较差异无统计学意义(P>0.05)。结论:瑞马唑仑联合舒芬太尼可降低行FESS治疗的慢性鼻窦炎伴鼻息肉患者术后疼痛及躁动程度,稳定血流动力学,减轻应激反应,且可缩短苏醒时间,具有一定安全性。
Abstract:
Objective:To investigate the clinical value of remimazolam combined with sufentanil in functional endoscopic sinus surgery(FESS)for chronic rhinosinusitis with nasal polyps.Methods:A total of 82 patients with chronic rhinosinusitis with nasal polyps scheduled for FESS were randomly divided into two groups:the control group(administered propofol combined with sufentanil anesthesia)and the study group(administered remimazolam combined with sufentanil anesthesia),with 41 cases in each group.Visual analog scale(VAS)scores and Ramsay sedation scores were recorded and compared at 2,6,12 and 24 hours postoperatively between the two groups.Heart rate,systolic blood pressure,diastolic blood pressure and mean arterial pressure were compared at five time points:before anesthesia(T0),during intubation(T1),during endoscope insertion(T2),during polypectomy(T3)and 10 minutes after extubation(T4).Serum levels of norepinephrine(NE),cortisol(Cor)and catalase(CAT)were compared preoperatively and at 2,12,24 and 48 hours postoperatively.Additionally,the time to leave the operating room,time to spontaneous breathing recovery,anesthesia onset time and awakening time were compared between the two groups.The incidence of postoperative adverse reactions was also evaluated.Results:The study group had lower VAS scores at 2,6 and 12 hours postoperatively and higher Ramsay sedation scores compared to the control group(all P<0.05).At T1,T2 and T3,the study group had higher heart rates but lower systolic blood pressure,diastolic blood pressure and mean arterial pressure compared to the control group(all P<0.05).Serum levels of Cor,NE and CAT at 2,12,24 and 48 hours postoperatively were lower in the study group than in the control group(all P<0.05).The anesthesia onset time was longer,and the awakening time was shorter in the study group compared to the control group(all P<0.05).There was no significant difference in the incidence of postoperative adverse reactions between the two groups(P>0.05).Conclusion:Remimazolam combined with sufentanil can reduce postoperative pain and agitation,stabilizes hemodynamics,alleviates stress responses,shortens awakening time,and demonstrates favorable safety in chronic rhinosinusitis with nasal polyps patients undergoing FESS.

参考文献/References:

[1] 许庚.嗜酸粒细胞增多性慢性鼻窦炎伴鼻息肉的围手术期处理:我的理解与经验[J].中华耳鼻咽喉头颈外科杂志,2023,58(12):1254-1258.
[2] 冯兴龙,蒲军成,赵星,等.舒芬太尼联合瑞芬太尼麻醉诱导在内镜黏膜下剥离术中的应用[J].川北医学院学报,2021,36(12):1593-1596.
[3] 张士民,吴华彬,徐文庆.瑞马唑仑与丙泊酚分别复合瑞芬太尼麻醉对老年髋关节骨折患者BIS及认知功能的影响[J].海南医学,2023,34(18):2674-2677.
[4] 刘鹏,梁贇,张闪闪,等.瑞马唑仑与丙泊酚应用于无痛胃肠镜安全性及有效性Meta分析[J].陕西医学杂志,2022,51(6):753-759.
[5] HORVATH B,KLOESEL B,TODD M M,et al.The evolution,current value,and future of the American society of anesthesiologists physical status classification system[J].Anesthesiology,2021,135(5):904-919.
[6] 张红杰.鼻内镜手术治疗慢性鼻窦炎的临床效果及其与临床分型的关系探讨[J].中国现代药物应用,2020,14(2):71-73.
[7] SAIDIE S,MODIR H,YAZDI B,et al.The effect of dexmedetomidine on decrease of cough,hemodynamic parameters and Ramsay score versus lidocaine during general anesthesia:A randomized clinical trial[J].Med Gas Res,2021,11(1):1-5.
[8] 李睿,李理,魏嘉,等.全麻患者术后苏醒延迟情况及影响因素分析[J].华南预防医学,2024,50(3):222-226.
[9] 李成,郑栋煜,袁红斌,等.全麻诱导期血流动力学管理的研究进展[J].临床麻醉学杂志,2022,38(5):544-548.
[10] 和浩杰,杨建新,南官江,等.基于多个基因多态性的术后舒芬太尼镇痛效应[J].山西医科大学学报,2023,54(9):1274-1279.
[11] 程勤耘,尹学军,汪明珠.舒芬太尼或地佐辛复合右美托咪定对经腹子宫切除术后的镇痛效果[J].临床误诊误治,2023,36(4):131-135.
[12] 顾庆玲,黄民,李嘉丽.丙泊酚药物不良反应潜在机制的研究现状[J].中国临床药理学杂志,2023,39(12):1815-1819.
[13] 赵凯旋,韩盈,杨宁,等.麻醉药丙泊酚成瘾机制的研究现状[J].中国药物依赖性杂志,2022,31(6):411-416.
[14] 邵菁菁.瑞马唑仑联合舒芬太尼在行胸腔镜手术患者中的麻醉效果[J].山西医药杂志,2022,51(24):2817-2820.
[15] 贺小玲,刘苏漫,姚文壮,等.瑞马唑仑对胸腔镜肺叶切除术老年病人血流动力学及术后认知功能的影响[J].中西医结合心脑血管病杂志,2024,22(19):3619-3623.
[16] 俞海博,吴明正,代帅,等.血流动力学不稳定的临床特征分析及预测模型的构建[J].中国急救医学,2024,44(6):509-514.
[17] 余婉秋,李禹琼,朱圣姬,等.苯磺酸瑞马唑仑与丙泊酚用于无痛结肠镜检查的有效性及安全性的随机、单盲、平行对照研究[J].贵州医药,2020,44(6):846-849.
[18] 刘小红,姚军,卢清旺,等.瑞马唑仑复合舒芬太尼在超声引导神经阻滞期间的镇静镇痛效果[J].中国微创外科杂志,2024,24(3):190-195.
[19] 段声吉,冉鑫,张杰,等.瑞马唑仑对麻醉诱导期脑电双频指数及血流动力学的影响[J].国际麻醉学与复苏杂志,2022,43(7):682-685.
[20] 马菲,李斐,李雪娟.鼻内镜Messerklinger中鼻甲成形术对慢性鼻-鼻窦炎伴鼻息肉患者鼻腔功能及炎性应激反应的影响[J].广东医学,2020,41(22):2317-2321.
[21] 彭赛,熊武.针刺联合全麻对老年腹部手术患者苏醒期躁动、应激反应及术后认知功能的影响[J].陕西中医,2021,42(4):517-519.
[22] 俞晓东,张文奇,康文越,等.瑞马唑仑联合舒芬太尼对行胸腔镜手术患者炎症因子及疼痛介质和应激反应指标水平的影响[J].中国医药,2022,17(1):93-97.
[23] 刘志杰,陈永学,赵兴,等.不同剂量瑞马唑仑麻醉诱导对气管插管全身麻醉腹部手术患者血流动力学水平及应激反应的影响[J].中国医刊,2024,59(8):895-898.
[24] 史媛,董贝贝,于泳浩.胃肠内镜检查中镇静镇痛药物应用的研究进展[J].中国医药导报,2020,17(34):64-67.
[25] SNEYD J R,RIGBY-JONES A E.Remimazolam for anaesthesia or sedation[J].Curr Opin Anaesthesiol,2020,33(4):506-511.
[26] 袁君晓寒,白晓峰,张霞.新型镇静药瑞马唑仑药代动力学及药效学研究进展[J].实用药物与临床,2024,27(3):216-221.

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备注/Memo

备注/Memo:
[基金项目]河南省医学科技攻关计划项目(LHGJ20229588)
更新日期/Last Update: 2025-05-05