【摘要】 目的 探讨不同剂量瑞马唑仑全麻诱导对肝癌根治术患者的镇静效果及血流动力学的影响。方法 选择2020年5月至2021年2月在江门市中心医院接受肝癌根治术的60例患者进行研究，按随机数表法分为A组、B组和C组，每组20例。三组患者均使用瑞马唑仑进行全麻诱导，A组按0.2 mg/kg剂量进行、B组按0.3 mg/kg剂量进行、C组按0.4 mg/kg剂量进行，三组患者术中其余麻醉方式相同。比较三组患者围术期情况、麻醉起效时间、诱导期的脑电双频指数(BIS)，并比较诱导开始时(T0)、BIS值≤60时(T1)以及气管插管后(T2)时心率(HR)、平均动脉压(MAP)的变化及术中不良反应发生情况。结果 A组瑞马唑仑补救患者为20.00%，明显多于B组的0和C组的0，差异有统计学意义(P<0.05)，而B组和C组瑞马唑仑补救患者比较差异无统计学意义(P>0.05);C组患者麻醉起效时间为(50.85±7.26) s，明显快于B组的(62.11±9.63) s和A组的(73.92±14.40) s，且B组患者麻醉起效时间明显快于A组，差异均有统计学意义(P<0.05)；三组患者诱导期BIS值及T1、T2、T3时间点的HR、MAP比较差异均无统计学意义(P>0.05)；三组患者术中不良反应总发生率比较差异无统计学意义(P>0.05)。结论 瑞马唑仑全麻诱导对肝癌根治术患者的镇静效果较好，且可保持术中血流动力学稳定，其中0.3 mg/kg为最佳剂量。更多还原

【Abstract】 Objective To study the sedative effect and hemodynamic influence of different doses of remazolam induced by general anesthesia in patients undergoing radical hepatectomy. Methods Sixty patients with liver cancer who underwent radical resection in Jiangmen Central Hospital from May 2020 to February 2021 were selected. They were divided into group A, group B, and group C by random number table method, with 20 patients in each group. All patients were induced by general anesthesia with rimazolam in the three groups, with dosage of 0.2 mg/kg in group A,the dosage of 0.3 mg/kg in group B, and the dosage of 0.4 mg/kg in group C. Other anesthesia methods were the same among the three groups. The perioperative situation, anesthesia onset time, bispectral index(BIS) during induction period were compared among the three groups. The changes of heart rate(HR) and mean arterial pressure(MAP) at the beginning of induction(T0), BIS≤60(T1), and after tracheal intubation(T2) and the occurrence of intraoperative adverse reactions were compared among the three groups. Results The proportion of reomazolam remedies in group A was20.00%, which was significantly more than 0 in group B and 0 in group C(P<0.05); and there was no significant difference between group B and group C in the proportion of reomazolam remedies(P>0.05). The onset time of anesthesia in group C was(50.85±7.26) s, which were significantly faster than(62.11±9.63) s in group B and(73.92±14.40) s in group A, while the onset time of anesthesia in group B was significantly faster than that in group A, with statistically significant differences(P<0.05). There was no significant difference in BIS value in the induction phase and HR and MAP at T1, T2 and T3 time points among the three groups(P>0.05). There was no significant difference in the total incidence of intraoperative adverse reactions among the three groups(P>0.05). Conclusion The general anesthesia induction with rimazole have a good sedative effect in patients undergoing radical hepatectomy, and it can keep the hemodynamics stable during the operation, of which the best dose is 0.3 mg/kg.更多还原