瑞马唑仑用于全麻诱导安全有效吗？

苯磺酸瑞马唑仑于2020年7月正式获批上市，用于无痛诊疗镇静、全身麻醉、ICU镇静以及局麻镇静等领域。那么瑞马唑仑与传统静脉麻醉药丙泊酚相比，效果及安全性如何呢？瑞马唑仑能用于临床麻醉诱导吗？

下面分享一篇随机对照研究，比较瑞马唑仑和丙泊酚用于麻醉诱导的效果，让我们一起看看其结果如何吧？

摘要译文

瑞马唑仑与丙泊酚用于全麻诱导的安全性和有效性比较

背景：

瑞马唑仑是一种新型的超短效苯二氮卓类麻醉剂，在无痛胃肠镜检查中具有可预测的镇静时间和快速恢复的特点。丙泊酚是临床工作中常用的静脉麻醉药，具有起效快、起效时间短、恢复快等优点。到目前为止，比较这种药物用于全麻诱导的文章相对较少。因此，我们进行了一项随机对照试验，以评估瑞马唑仑在麻醉诱导期间的有效性和安全性是否优于丙泊酚。

方法：

189例ASAⅠ-Ⅱ级择期手术患者被随机分为4组：瑞马唑仑0.2mg/kg组（R1组）、0.3mg/kg组（R2组）、0.4mg/kg组（R3组）和丙泊酚组（P组）。所有患者均在诱导期单次注射实验药物。通过完成麻醉诱导而无需加用补救性镇静药来衡量疗效，安全性被定义为无严重不良事件。

结果：

瑞马唑仑组诱导成功率为89%（R1组）、94%（R2组）和100%（R3组），P组诱导成功率为100%。R1组（13%）和R2组（24%）诱导期低血压发生率低于P组（44%）。R3组低血压发生率（34%）与丙泊酚（44%）相似。P组注射部位疼痛发生率为27%，R组无疼痛发生。

结论：

瑞马唑仑是一种安全有效的镇静药物，用于ASAⅠ-Ⅱ级患者的全麻，不良反应少。

原文摘要

Safety and efficacy of remimazolam compared withpropofol in induction of general anesthesia

Background:

Remimazolam is a new ultra-short actingbenzodiazepine anesthetic which has predictable sedative duration and rapidrecovery in gastrointestinal endoscopy. Propofol is a commonly used intravenousanesthetic in clinical work which also has rapid action, short action time andrapid recovery. To date, there have been relatively few articles comparing thetwo for general anesthesia induction. So we conducted a randomized trial toevaluate whether remimazolam is superior to propofol during anesthesiainduction in terms of the efficacy and safety.

Methods:

One hundred and eighty nine ASA I or II patientsscheduled for elective surgery were divided into four groups: remimazolam0.2mg/kg (group R1), 0.3mg/kg(group R2), 0.4mg/kg(group R3), and propofolgroup(group P). All patients were anesthetized with single shot of experimentaldrugs during induction period. Efficacy was measured by completing the inductionof anesthesia without rescue sedation and safety was defined as no severeadverse events.

Results:

Success induction rates in remimazolam groupswere 89%(group R1), 94%(group R2) and 100%(group R3) while success inductionrate in group P was 100%. Hypotension rates during induction were lower in R1group (13%) and R2 group (24%) compared with group P (44%). Hypotension rate inR3 group (34%) was similar to propofol (44%). Injection site pain in group Pwas 27% while no pain was observed in remimazolam groups.

Conclusions:

Remimazolam is a safe and effective sedative drugduring induction with less adverse effects for general anesthesia in ASA I or II patients.

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