苯磺酸瑞马唑仑对全身麻醉患者的镇静效果及脑血流的影响

Sedative Effect and Cerebral Blood Flow Impact of Remimazolam Benzenesulfonate on Patients Undergoing General Anesthesia

摘要: 目的：探讨苯磺酸瑞马唑仑对全身麻醉患者的镇静效果及脑血流的影响。方法：回顾性选取2022年1月~2024年1月于枣庄市立医院行全身麻醉的126例患者，根据麻醉诱导方案分为P组(n = 65)和RB组(n = 61)。P组给予丙泊酚(1.5~2.0 mg/kg)诱导麻醉，RB组给予苯磺酸瑞马唑仑(0.3 mg/kg)诱导麻醉。收集并分析两组意识丧失时间(LOC)、停药清醒时间、各时间节点[术前(T0)、诱导后(T1)、意识消失1 min (T2)、意识消失2 min (T3)、插管前(T4)]脑电双频指数(BIS)、状态指数(PSI)、频谱边缘频率(SEF)、平均动脉压(MAP)、心率(HR)、心脏指数(CI)、左侧大脑中动脉平均血流速度(Vm)、阻力指数(RI)和局部脑氧饱和度(rScO₂)，统计不良反应发生情况。结果：RB组LOC、停药清醒时间、不良反应发生率均低于P组(均P < 0.05)。RB组PSI、SEF、Vm、RI、rSrO₂在T1~T3节点均高于P组(均P < 0.05)；RB组BIS在T2~T3节点均高于P组(均P < 0.05)；RB组MAP、HR、CI在T1~T4节点均高于P组(均P < 0.05)。结论：苯磺酸瑞马唑仑(0.3 mg/kg诱导，1.0~2.0 mg/kg/h维持)用于全身麻醉患者，可获得较丙泊酚更快的意识丧失与苏醒恢复、更稳定的血流动力学及脑血流参数，且不良反应发生率较低。

Abstract: Objective: To explore sedative effect and cerebral blood flow impact of remimazolam benzenesulfonate on patients undergoing general anesthesia. Methods: Retrospectively 126 patients who underwent general anesthesia in Zaozhuang Municipal Hospital from January 2022 to January 2024 were selected for the study and were divided into P group (n = 65) and RB group (n = 61) according to anesthesia induction protocol. P group was induced with propofol (1.5~2.0 mg/kg) for anesthesia, and RB group was induced with remimazolam benzenesulfonate (0.3 mg/kg) for anesthesia. The time of loss of consciousness (LOC) and time of wakefulness after drug withdrawal in the two groups were compared. Bifrequency index (BIS), patient state index (PSI), spectral edge frequency (SEF), mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), mean blood flow velocity of left middle cerebral artery (Vm), and regional cerebral Saturation oxygenation (rScO₂) were collected and analyzed in the two groups at each time node [preoperative (T0), postinduction (T1), loss of consciousness for 1 min (T2), loss of consciousness for 2 min (T3), and before intubation (T4)]. The occurrence of adverse reactions was recorded and counted in both groups. Results: LOC, recovery time and incidence of adverse reactions in RB group were lower than those in P group (all P < 0.05). PSI, SEF, Vm, RI and rScO₂ in RB group were higher than those in P group at T1~T3 (all P < 0.05). BIS in RB group was higher than that in P group at T2~T3 (all P < 0.05). MAP, HR and CI in RB group were higher than those in P group at T1~T4 nodes (all P < 0.05). Conclusion: Remimazolam benzenesulfonate provides better sedation with more stable cerebral hemodynamics in patients under general anesthesia and has a high safety profile.