瑞马唑仑与丙泊酚在腹腔镜胆囊切除术或阑尾切除术中对血流动力学稳定性及苏醒质量的影响比较

Comparison of the Effects of Remimazolam and Propofol on Hemodynamic Stability and Recovery Quality during Laparoscopic Cholecystectomy or Appendectomy

摘要: 目的：探讨瑞马唑仑在腹腔镜胆囊切除术或阑尾切除术全身麻醉中的应用效果，并与丙泊酚比较其在血流动力学稳定性、苏醒质量及不良反应发生率方面的差异。方法：采用回顾性研究方法，选取接受腹腔镜胆囊切除术或阑尾切除术的患者作为研究对象，根据麻醉诱导和维持用药不同分为瑞马唑仑组和丙泊酚组，各100例。比较两组患者术中血流动力学指标变化、苏醒时间、拔管时间及不良反应发生情况。结果：与丙泊酚组相比，瑞马唑仑组患者术中血流动力学波动较小，循环稳定性更佳；苏醒时间及拔管时间均明显缩短；术中及术后不良反应发生率显著降低，差异具有统计学意义(p < 0.05)。结论：与丙泊酚相比，瑞马唑仑用于腹腔镜胆囊切除术或阑尾切除术全身麻醉可更有效地维持术中血流动力学稳定，改善苏醒质量，缩短苏醒及拔管时间，并减少不良反应的发生，具有良好的安全性和有效性，尤其适合用于日间腹腔镜手术。

Abstract: Objective: To investigate the application effect of remimazolam in general anesthesia for laparoscopic cholecystectomy or appendectomy, and to compare the differences in hemodynamic stability, recovery quality and incidence of adverse reactions between remimazolam and propofol. Methods: A retrospective study was conducted. Patients undergoing laparoscopic cholecystectomy or appendectomy were selected as the study subjects and divided into remimazolam group and propofol group according to different drugs for anesthesia induction and maintenance. The changes of hemodynamic indexes, recovery time, extubation time and adverse reactions during operation were compared between the two groups. Results: Compared with the propofol group, the remimazolam group had smaller hemodynamic fluctuations during the operation and better circulatory stability; the recovery time and extubation time were significantly shortened; the incidence of adverse reactions during and after the operation was significantly reduced, and the difference was statistically significant (p < 0.05). Conclusion: Compared with propofol, remimazolam used for general anesthesia in laparoscopic cholecystectomy or appendectomy can more effectively maintain intraoperative hemodynamic stability, improve the quality of recovery, shorten the recovery and extubation time, and reduce the occurrence of adverse reactions. It has good safety and effectiveness, and is especially suitable for day laparoscopic surgery.