【摘要】 目的 探讨瑞马唑仑复合曲马多在膀胱镜相关手术中的应用效果。方法 120例行膀胱镜相关短小手术的患者,采用随机抽签法分为对照组和观察组,每组60例。对照组采用丙泊酚复合曲马多进行麻醉,观察组采用瑞马唑仑复合曲马多进行麻醉。比较两组患者麻醉药物起效时间、苏醒时间、镇静成功率、体动反应情况,不同时间点[麻醉前（T0）、睫毛反射消失（T1）、进镜时（T2）、操作至5 min时（T3）、退镜时（T4）、麻醉苏醒时（T5）]生命体征[心率（HR）、平均动脉压（MAP）、血氧饱和度（SpO₂）],不良反应发生情况。结果 两组麻醉药物起效时间、镇静成功率比较,差异无统计学意义（P>0.05）；观察组苏醒时间（3.81±1.03）min短于对照组的（8.62±1.87）min,体动反应发生率3.33%低于对照组的15.00%,差异有统计学意义（P<0.05）。观察组T0、T1、T2、T3、T4、T5时MAP分别为（85.65±5.23）、（85.96±5.72）、（86.74±5.67）、（86.69±5.71）、（86.96±4.67）、（86.31±5.67）mm Hg（1 mm Hg=0.133 kPa）, HR分别为（73.93±4.67）、（74.41±4.31）、（74.73±4.57）、（75.15±3.98）、（74.93±3.67）、（74.53±3.87）次/min,SpO₂分别为（97.15±1.23）%、（96.94±1.82）%、（96.74±1.17）%、（96.69±1.31）%、（96.76±1.37）%、（96.94±1.67）%；对照组T0、T1、T2、T3、T4、T5时MAP分别为（85.64±5.67）、（82.05±4.63）、（80.34±4.46）、（81.65±4.07）、（82.87±4.07）、（83.08±4.66）mm Hg, HR分别为（73.65±4.66）、（70.35±3.67）、（68.51±3.34）、（69.67±3.67）、（71.64±4.02）、（72.07±3.57）次/min, SpO₂分别为（97.64±1.66）%、（94.25±1.63）%、（93.04±1.06）%、（91.57±1.61）%、（93.64±1.07）%、（94.01±0.66）%。观察组T1、T2、T3、T4、T5时MAP、HR、SpO₂与T0时比较,差异无统计学意义（P>0.05）；对照组T1、T2、T3、T4、T5时MAP、HR、SpO₂均明显低于T0时,差异有统计学意义（P<0.05）;T0时,两组MAP、HR、SpO₂比较,差异无统计学意义（P>0.05）;T1、T2、T3、T4、T5时,观察组MAP、HR、SpO₂均高于对照组,差异有统计学意义（P<0.05）。观察组不良反应发生率15.00%低于对照组的33.33%,差异有统计学意义（P<0.05）。结论 膀胱镜相关手术中,瑞马唑仑复合曲马多的麻醉效果优于丙泊酚复合曲马多麻醉,应用瑞马唑仑复合曲马多麻醉可降低对患者血流动力学的影响,且不良反应少,值得临床推广。更多还原

【Abstract】 Objective To discuss the application effect of remimazolam combined with tramadol in cystoscopy related surgery. Methods A total of 120 patients undergoing minor surgeries related to cystoscopy were divided into a control group and an observation group according to random lottery method, with 60 cases in each group. The control group was anesthetized with propofol and tramadol, and the observation group was anesthetized with remimazolam and tramadol. Both groups were compared in terms of onset time of anesthetic drugs, recovery time, successful rate of sedation, body movement, vital signs [heart rate（HR）, mean arterial pressure（MAP）, blood oxygen saturation（SpO₂）] at different time points [before anesthesia（T0）, eyelash reflex disappearance（T1）, endoscopic（T2）, operation to 5 min（T3）, endoscopic withdrawal（T4）, recovery from anesthesia（T5）], and the occurrence of adverse reactions. In the observation group, MAP at T0, T1, T2, T3, T4 and T5were（85.65±5.23）,（85.96±5.72）,（86.74±5.67）,（86.69±5.71）,（86.96±4.67） and（86.31±5.67） mm Hg（1 mm Hg= 0.133 kPa）, HR were（73.93±4.67）,（74.41±4.31）,（74.73±4.57）,（75.15±3.98）,（74.93±3.67）and（74.53±3.87） beats/min, SpO₂ were（97.15±1.23） %,（96.94±1.82） %,（96.74±1.17） %,（96.69±1.31） %,（96.76±1.37） % and（96.94±1.67） %. In the control group, MAP at T0, T1, T2, T3, T4 and T5 were（85.64±5.67）,（82.05±4.63）,（80.34±4.46）,（81.65±4.07）,（82.87±4.07） and（83.08±4.66） mm Hg, HR were（73.65±4.66）,（70.35±3.67）,（68.51±3.34）,（69.67±3.67）,（71.64±4.02） and（72.07±3.57） beats/min, SpO₂ were（97.64±1.66） %,（94.25±1.63） %,（93.04±1.06） %,（91.57±1.61） %,（93.64±1.07） % and（94.01±0.66） %.In the observation group, MAP, HR and SpO₂ at T1, T2, T3, T4 and T5 were not significantly different from those at T0（P > 0.05）. In the control group, MAP, HR and SpO₂ at T1, T2, T3, T4 and T5 were significantly lower than those at T0, and the differences were statistically significant（P<0.05）. At T0, there was no statistically significant difference in MAP, HR and SpO₂ between the two groups（P>0.05）. At T1, T2, T3, T4 and T5, MAP, HR and SpO₂ in the observation group were higher than those in the control group, and the differences were statistically significant（P<0.05）. The incidence of adverse reactions in the observation group was 15.00%, which was lower than that of 33.33% in the control group, and the difference was statistically significant（P<0.05）. Results There was no statistically significant difference in onset time of anesthetic drugs and successful rate of sedation between the two groups（P>0.05）. The recovery time of（3.81±1.03） min in the observation group was shorter than that of（8.62±1.87） min in the control group, and the incidence of body movement of 3.33% was lower than that of 15.00% in the control group. The difference were statistically significant（P<0.05）. Conclusion In cystoscopy related surgery, the anesthesia effect of remimazolam combined with tramadol is better than that of propofol combined with tramadol. Remimazolam combined with tramadol anesthesia can reduce the influence on the hemodynamics of patients, and has less complications, which is worthy of clinical promotion.更多还原