PDF(Pubmed)
Abstract：
UNASSIGNED: Remimazolam tosilate is a novel ultrafast-acting benzodiazepine that has a rapid emergence even after continuous infusion when using flumazenil. So far, relatively few articles are still focusing on the quality of recovery after general anesthesia with remimazolam, especially in day surgery. This study aimed to compare the early postoperative quality of recovery of remimazolam tosilate with flumazenil and propofol in patients undergoing day surgery.
UNASSIGNED: 137 patients scheduled for day surgery were randomly divided into the remimazolam tosilate or propofol group. The primary endpoint was the incidence of overall recovery assessed with the early postoperative quality of recovery scale (PostopQRS) on postoperative day 1 (POD 1). The Richmond Agitation-Sedation Scale (RASS) scores in the post-anesthesia care unit (PACU), extubation time, postoperative recovery profiles, and perioperative data were documented. Any adverse events were recorded.
UNASSIGNED: The incidence of overall recovery on POD1 was 47.7% in the remimazolam tosilate group and 65.1% in the propofol group (odds ratio, 0.52; 95% confidence interval (CI) 0.26 to 1.06; P = 0.072). In general, the overall recovery of the PostopQRS increased over time, and its interaction between time and group was significant (P = 0.003). Among the five dimensions of PostopQRS, there exist statistical differences between groups including emotional state and cognitive recovery. Upon arrival at the PACU, the remimazolam group was more sedated and took longer to recover to a RASS score similar to propofol. The frequency of application of vasoactive drugs during anesthesia was similar in both groups (P = 0.119). Despite rapid emergence with remimazolam after flumazenil reversal, re-sedation (10.8%) or somnolence (60%) in the PACU was observed, and the length of PACU stay in patients treated with remimazolam tosilate was longer than that of the propofol (35 min vs 30 min, P<0.001).
UNASSIGNED: General anesthesia with remimazolam tosilate in conjunction with flumazenil reversal permits rapid recovery of consciousness in day surgery, but there was a notable occurrence of re-sedation or somnolence observed in PACU.
UNASSIGNED: 137 patients scheduled for day surgery were randomly divided into the remimazolam tosilate or propofol group. The primary endpoint was the incidence of overall recovery assessed with the early postoperative quality of recovery scale (PostopQRS) on postoperative day 1 (POD 1). The Richmond Agitation-Sedation Scale (RASS) scores in the post-anesthesia care unit (PACU), extubation time, postoperative recovery profiles, and perioperative data were documented. Any adverse events were recorded.
UNASSIGNED: The incidence of overall recovery on POD1 was 47.7% in the remimazolam tosilate group and 65.1% in the propofol group (odds ratio, 0.52; 95% confidence interval (CI) 0.26 to 1.06; P = 0.072). In general, the overall recovery of the PostopQRS increased over time, and its interaction between time and group was significant (P = 0.003). Among the five dimensions of PostopQRS, there exist statistical differences between groups including emotional state and cognitive recovery. Upon arrival at the PACU, the remimazolam group was more sedated and took longer to recover to a RASS score similar to propofol. The frequency of application of vasoactive drugs during anesthesia was similar in both groups (P = 0.119). Despite rapid emergence with remimazolam after flumazenil reversal, re-sedation (10.8%) or somnolence (60%) in the PACU was observed, and the length of PACU stay in patients treated with remimazolam tosilate was longer than that of the propofol (35 min vs 30 min, P<0.001).
UNASSIGNED: General anesthesia with remimazolam tosilate in conjunction with flumazenil reversal permits rapid recovery of consciousness in day surgery, but there was a notable occurrence of re-sedation or somnolence observed in PACU.
摘要：
■甲苯磺酸雷马唑仑是一种新型的超快作用苯二氮卓类药物，即使在使用氟马西尼时连续输注后也会迅速出现。到目前为止,相对较少的文章仍然关注雷米唑仑全身麻醉后的恢复质量，尤其是在日间手术中。这项研究旨在比较接受日间手术的患者的甲苯磺酸雷米咪唑安定与氟马西尼和异丙酚的术后早期恢复质量。
■137例进行日间手术的患者随机分为甲苯磺酸瑞米唑仑或异丙酚组。主要终点是在术后第1天（POD1）使用术后早期恢复质量量表（PostopQRS）评估的总体恢复发生率。麻醉后监护病房（PACU）的里士满激动镇静量表（RASS）评分，拔管时间,术后恢复情况，并记录围手术期数据。记录任何不良事件。
■对POD1的总体恢复的发生率在甲苯磺酸雷米唑仑组为47.7%，在异丙酚组为65.1%(比值比,0.52；95%置信区间（CI）0.26至1.06；P=0.072）。总的来说,PostopQRS的整体恢复随着时间的推移而增加，时间与组之间的交互作用显著(P=0.003)。在PostopQRS的五个维度中，情绪状态和认知恢复组间存在统计学差异。到达PACU后，雷米唑仑组的镇静作用更强,恢复至与异丙酚相似的RASS评分需要更长的时间.两组麻醉期间血管活性药物的应用频率相似(P=0.119)。尽管在氟马西尼逆转后出现了瑞马唑仑，观察到PACU中的镇静（10.8％）或嗜睡（60％），用瑞咪唑安定治疗的患者的PACU停留时间长于异丙酚（35分钟vs30分钟，P<0.001)。
■全身麻醉与甲苯磺酸瑞咪唑仑联合氟马西尼逆转可在日间手术中迅速恢复意识，但在PACU中观察到明显的再镇静或嗜睡。
■137例进行日间手术的患者随机分为甲苯磺酸瑞米唑仑或异丙酚组。主要终点是在术后第1天（POD1）使用术后早期恢复质量量表（PostopQRS）评估的总体恢复发生率。麻醉后监护病房（PACU）的里士满激动镇静量表（RASS）评分，拔管时间,术后恢复情况，并记录围手术期数据。记录任何不良事件。
■对POD1的总体恢复的发生率在甲苯磺酸雷米唑仑组为47.7%，在异丙酚组为65.1%(比值比,0.52；95%置信区间（CI）0.26至1.06；P=0.072）。总的来说,PostopQRS的整体恢复随着时间的推移而增加，时间与组之间的交互作用显著(P=0.003)。在PostopQRS的五个维度中，情绪状态和认知恢复组间存在统计学差异。到达PACU后，雷米唑仑组的镇静作用更强,恢复至与异丙酚相似的RASS评分需要更长的时间.两组麻醉期间血管活性药物的应用频率相似(P=0.119)。尽管在氟马西尼逆转后出现了瑞马唑仑，观察到PACU中的镇静（10.8％）或嗜睡（60％），用瑞咪唑安定治疗的患者的PACU停留时间长于异丙酚（35分钟vs30分钟，P<0.001)。
■全身麻醉与甲苯磺酸瑞咪唑仑联合氟马西尼逆转可在日间手术中迅速恢复意识，但在PACU中观察到明显的再镇静或嗜睡。
