■苯磺酸雷马唑仑是一种新型的超短效苯二氮卓类药物,可通过组织脂肪酶快速水解为唑吡坦丙酸。我们设计了这项研究,以比较瑞马唑仑苯磺酸阿芬太尼与右美托咪定-阿芬太尼用于纤维支气管镜检查(FB)的安全性和有效性。
■这项前瞻性随机对照试验的120名接受FB的患者分为两组。麻醉诱导由RA组6mg/kg/h苯磺酸瑞米唑仑和DA组0.5μg/kg右美托咪定组成。在FB期间,给予1-2mg/kg/h的苯磺酸瑞马唑仑或0.2-0.7µg/kg/h的右美托咪定以维持。最低的氧饱和度,FB成功率,血流动力学,时间指标,支气管镜检查的可行性,药物剂量要求,患者和支气管镜医生满意度评分,术中意识的发生,愿意用相同的镇静方案重复FB的患者人数,以及不良事件的发生和严重程度。
■RA组FB期间的最低血氧饱和度显着升高(P=0.001)。与DA组中的变量相比,外周血氧饱和度,收缩压,RA组T2、T3时舒张压均明显降低(P<0.05)。从T2到T4,DA组的心率明显升高(P<0.05)。DA组出现心动过缓的患者较多(P=0.041)。与DA组中的时间指标相比,感应时间,全警戒时间,RA组恢复离室时间均明显缩短(P<0.05)。RA组的支气管镜可行性评分在T2时显着降低,而DA组在T3时显着降低(P<0.05)。
■在FB期间与阿芬太尼联用时,苯磺酸瑞马唑仑优于右美托咪定,促进患者更快的康复,更好的手术条件和呼吸稳定性,不良事件的发生率和严重程度相似。
UNASSIGNED: Remimazolam besylate is a novel ultra-short-acting benzodiazepine that is rapidly hydrolyzed to zolpidem propionic acid by tissue lipases. We designed this study to compare the safety and efficacy of remimazolam besylate alfentanil versus dexmedetomidine-alfentanil for fiberoptic
bronchoscopy (FB).
UNASSIGNED: One hundred and twenty patients undergoing FB into this prospective randomized controlled trial were divided into two groups. The anesthesia induction consisted of 6 mg/kg/h of remimazolam besylate in the RA group and 0.5 μg/kg of dexmedetomidine in the DA group. 1-2 mg/kg/h of remimazolam besylate or 0.2-0.7 µg/kg/h of dexmedetomidine were administered to maintain during FB. The lowest oxygen saturation, success rate of FB, hemodynamics, time metrics,
bronchoscopy feasibility, drug dose requirements, patient and bronchoscopist satisfaction scores, occurrence of intraoperative awareness, number of patients willing to repeat FB with the same sedation regimen, and occurrence and severity of adverse events.
UNASSIGNED: The lowest oxygen saturation during the FB was significantly higher in the RA group (P = 0.001). Compared with the variables in the DA group, peripheral oxygen saturation, systolic blood pressure, and diastolic blood pressure were significantly lower at T2 and T3 in the RA group (P < 0.05). Heart rates were significantly higher from T2 to T4 in the DA group (P < 0.05). More patients experienced bradycardia in the DA group (P = 0.041). Compared with time metrics in the DA group, the induction time, fully-alert time, and recovery room-leaving time were all significantly shorter in the RA group (P < 0.05). The
bronchoscopy feasibility scores in the RA group were significantly lower at T2, whereas they were lower at T3 in the DA group (P < 0.05).
UNASSIGNED: Remimazolam besylate is superior to dexmedetomidine when combined with alfentanil during FB, promoting faster patients\' recovery, better operative conditions and respiratory stability with similar rates of occurrence and severity of adverse events.