PDF(Pubmed)
Abstract：
Background: Cerebral aneurysm coil embolization is often performed under general anesthesia to prevent patient movement and sudden high blood pressure. However, the optimal anesthetic agent remains uncertain. This study aimed to determine whether maintaining anesthesia with remimazolam in patients undergoing coil embolization could avoid hypotension or hypertension compared to sevoflurane. Methods: Thirty-three adult patients participated in this single-blinded, randomized controlled trial. Patients in Group R were induced and maintained with remimazolam, whereas those in Group S received propofol and sevoflurane. Results: The use of remimazolam significantly reduced the incidence of intraoperative hypotension events (33.3% vs. 80.0%; p = 0.010) but did not change the incidence of hypertension events (66.7% vs. 73.3%; p = 0.690). Patients in Group R maintained a significantly higher range of maximal (100.2 ± 16.6 vs. 88.1 ± 13.5 mmHg; p = 0.037) and minimal (69.4 ± 6.6 vs. 63.4 ± 4.8 mmHg; p = 0.008) mean arterial blood pressure than those in Group S during the intervention. Conclusions: This is the first study to demonstrate the feasibility of maintaining general anesthesia with remimazolam in patients undergoing cerebral aneurysm coil embolization. The findings suggest that remimazolam may maintains better hemodynamic stability, reducing the incidence of hypotensive events without compromising patient safety.
摘要：
背景：脑动脉瘤线圈栓塞通常在全身麻醉下进行，以防止患者运动和突然高血压。然而,最佳麻醉剂仍不确定.这项研究旨在确定与七氟醚相比，在接受线圈栓塞的患者中维持雷米咪唑安定麻醉是否可以避免低血压或高血压。方法：33名成年患者参加了这项单盲研究，随机对照试验。R组患者用瑞咪唑安定诱导和维持，而S组患者接受异丙酚和七氟烷.结果：使用雷米唑仑可显着降低术中低血压事件的发生率（33.3％vs.80.0%；p=0.010），但没有改变高血压事件的发生率（66.7%vs.73.3%；p=0.690）。R组患者的最大范围（100.2±16.6vs.88.1±13.5mmHg；p=0.037）和最小值（69.4±6.6vs.63.4±4.8mmHg；p=0.008）干预期间平均动脉血压高于S组。结论：这是首次证明在接受脑动脉瘤弹簧圈栓塞的患者中维持雷米咪唑安定全身麻醉的可行性的研究。研究结果表明，瑞米唑仑可以保持更好的血流动力学稳定性，在不影响患者安全的情况下降低低血压事件的发生率。
