【摘要】 麻醉监测管理（MAC）是麻醉医生利用镇痛或镇静药物的同时密切监测未插管且保留自主呼吸的麻醉患者生命体征的一种技术手段，具有保留自主呼吸、避免机械通气造成的肺损伤、缩短术后恢复时间的优势。目前MAC方案主要为麻醉性镇静药联合镇痛药，常用的镇静药物有丙泊酚和咪达唑仑等，但是对呼吸循环有抑制作用，限制了其在临床中的开展。近年来新上市的苯二氮卓类镇静药物瑞马唑仑，是在咪达唑仑的基础上加入丙酸甲酯侧链，使其成为一种超短效静脉麻醉药。临床实践证明瑞马唑仑具有对呼吸和循环影响轻微、注射痛发生率低、起效快且代谢产物无活性等优点，在麻醉安全方面具有一定的优势。目前研究发现瑞马唑仑应用于MAC中能够起到稳定循环、减轻呼吸抑制、降低恶心呕吐等不良反应的作用，应用前景广阔，但在全身麻醉中的安全性和有效性仍需进一步探讨。本文将从瑞马唑仑的药理特点、围手术期应用优势以及尚需解决的问题等方面进行综述，为广大临床工作者提供参考。更多还原

【Abstract】 Monitored anesthesia care(MAC)is a technique in which anesthesiologists use analgesic or sedative drugs while closely monitoring the vital signs of patients undergoing anesthesia without intubation and with spontaneous breathing. Its advantages include maintaining patient’s spontaneous breathing,avoiding lung injury caused by mechanical ventilation,and shortening the postoperative recovery time. Currently,the drug regimens for MAC mainly consist of anesthetic sedatives combined with analgesics. Common sedative drugs include propofol and midazolam. However,they have inhibitory effects on the respiratory and circulatory systems,which limits their application in clinical practice. In recent years,a newly discovered anesthetic,remimazolam,is a short-acting intravenous anesthetic developed from midazolam by adding a methyl propionate side chain. Remimazolam has a minor effect on respiration and circulation,a low incidence of injection pain,rapid onset,and inactive metabolites,presenting certain advantages in terms of anesthetic safety. Existing research has found that remimazolam can stabilize circulation,reduce respiratory depression,and lower the incidence of adverse reactions such as nausea and vomiting when used in MAC,with broad application prospects. However,the safety and efficacy of remimazolam in general anesthesia still need to be confirmed. This article will review the pharmacological characteristics of remimazolam,its perioperative application advantages,and the problems that need to be solved,providing a reference for the majority of clinical practitioners.更多还原