瑞马唑仑复合纳布啡静脉麻醉用于无痛宫腔镜诊疗手术的临床观察

Clinical Observation of Remazolam Combined with Nalbuphine Intravenous Anesthesia for Painless Hysteroscopy

摘要: 目的：观察在宫腔镜诊疗操作中，瑞马唑仑复合纳布啡的有效性与安全性。方法：利用随机数表法将100名接受无痛宫腔镜手术的患者随机分配到丙泊酚组(P组)和瑞马唑仑组(R组)。P组患者予以纳布啡和丙泊酚；R组患者予以纳布啡和瑞马唑仑。在麻醉开始前(T0)、睫毛反射消失时(T1)、宫颈扩张时(T2)、手术结束时(T3)、术毕清醒时(T4)记录两组患者的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO₂)；记录手术时间、术后苏醒时间、PACU停留时间；记录呼吸抑制、血压异常、心率异常、体动反应和术后恶心、呕吐发生的情况。结果：T1~T3时R组的MAP、HR下降程度明显低于P组(P < 0.05)，T1~T2时R组的血氧饱和度的下降程度明显低于P组(P < 0.05)，R组的苏醒时间、PACU停留时间明显短于P组(P < 0.05)。R组的不良事件明显少于P组。结论：瑞马唑仑复合纳布啡能够安全有效地应用于宫腔镜诊疗的静脉麻醉，对循环和呼吸系统影响更小，注射痛发生率更低，优于丙泊酚复合纳布啡。

Abstract: Objective: To observe the efficacy and safety of remazolam combined with nalbuphine in hyster-oscopic diagnosis and treatment. Methods: 100 patients who underwent painless hysteroscopy were selected and divided into propofol group (group P) and remazolam group (group R) by ran-dom number table. Group P was given nalbuphine and propofol; Group R was given nalbuphine and remazolam. The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO₂) were recorded before anesthesia (T0), when eyelash reflex disappeared (T1), when cervix was di-lated (T2), at the end of surgery (T3) and when awake after surgery (T4). Operation time, postoper-ative recovery time and PACU residence time were recorded. Respiratory depression, abnormal blood pressure, abnormal heart rate, body motor reaction, postoperative nausea and vomiting were recorded. Results: The decrease of MAP and HR in group R at T1~T3 was significantly lower than that in group P (P < 0.05), the decrease of blood oxygen saturation in group R at T1~T2 was signifi-cantly lower than that in group P (P < 0.05), and the recovery time and PACU residence time in group R were significantly shorter than that in group P (P < 0.05). The adverse events in group R were significantly less than those in group P. Conclusion: Remazolam combined with nalbuphine can be safely and effectively applied to intravenous anesthesia in hysteroscopic diagnosis and treatment, with less impact on circulation and respiratory system and lower incidence of injection pain, which is better than propofol combined with nalbuphine.