瑞马唑仑-瑞芬太尼在宫腔镜手术期间比瑞马唑仑-阿芬太尼引起的术后恶心呕吐更少：一项单中心随机对照试验

以下文章来源于罂粟花 ，作者anesthGH

本文由“罂粟花”授权转载   

瑞马唑仑-瑞芬太尼在宫腔镜手术期间比瑞马唑仑-阿芬太尼引起的术后恶心呕吐更少：一项单中心随机对照试验

贵州医科大学    麻醉与心脏电生理课题组

翻译：宋雨婷

编辑：宋雨婷

审校：曹莹

1背景

宫腔镜手术时间虽短，但术后恶心呕吐发生率较高。本研究的目的是比较在宫腔镜手术中瑞马唑仑与瑞芬太尼或阿芬太尼联合使用时术后恶心呕吐的发生率。

2方法

本研究为一项随机、对照、双盲试验。纳入拟行宫腔镜手术的患者并随机分为瑞马唑仑-瑞芬太尼组（RR组）或瑞马唑仑-阿芬太尼组（RA组）。两组患者甲苯磺酸瑞马唑仑诱导剂量为0.2mg/kg，维持剂量为1.0mg/kg/h。用甲苯磺酸瑞马唑仑诱导后，在RR组中，靶控输注瑞芬太尼使其目标浓度为1.5ng/ml；在RA组中，按照20μg/ kg的剂量给予阿芬太尼且输注时间不少于30S，后按照0.16μg/kg/min的速度进行维持。主要观察指标是术后恶心呕吐的发生率。次要观察指标是苏醒时间、在PACU的停留时间、瑞马唑仑的总剂量和不良事件（如SpO2降低，心动过缓，低血压和体动反应）的发生率。

3结果

共纳入204例患者。RR组术后恶心呕吐发生率（2/102，2.0%）显著低于RA组（12/102，11.8%）（P <0.05）。两组患者不良事件（如SpO2降低，心动过缓，低血压和体动反应）的发生率无显著差异（P > 0.05）。

4结论

在宫腔镜手术中，瑞马唑仑-瑞芬太尼引起的术后恶心呕吐比瑞马唑仑-阿芬太尼少。

原始文献来源：

Zhang, X., Li, S. & Liu, J. Remimazolam-remifentanil causes less postoperative nausea and vomiting than remimazolam-alfentanil during hysteroscopy: a single-centre randomized controlled trial. BMC Anesthesiol 23, 199 (2023). 

英文原文

Remimazolam-remifentanil causes less postoperative nausea and vomiting than remimazolam-alfentanil during hysteroscopy: a single-centre randomized controlled trial

Background: Although the operation time of hysteroscopy is short, the incidence of postoperative nausea and vomiting is high. The aim of this study was to compare the incidence of postoperative nausea and vomiting in hysteroscopy when remimazolam is combined with remifentanil or alfentanil.

Methods: We conducted a randomized, controlled, double-blind trial. Patients undergoing hysteroscopy were recruited and randomly assigned to either the remimazolam-remifentanil (Group RR) or the remimazolam-alfentanil group (Group RA). All patients in the two groups were started with an induction dose of remimazolam besylate 0.2 mg/kg and then maintained with a dosage of 1.0 mg/kg/h. After induction with remimazolam besylate, in Group RR, remifentanil was infused using a target-controlled infusion system with a target concentration of 1.5 ng/ml and titrated throughout the procedure. In Group RA, infusion of alfentanil was started with an initial bolus dose of 20 µg/kg over 30 s and then maintained at an initial rate of 0.16 µg/kg/min. The primary observation outcome was the incidence rate of postoperative nausea and vomiting. The secondary observation outcomes were the time to awakening, the length of stay in the PACU, the total remimazolam dose and adverse effects, such as low SpO2, bradycardia, hypotension and body movement.

Results: A total of 204 patients were successfully included in this study. The incidence of postoperative nausea and vomiting in Group RR (2/102, 2.0%) was significantly lower than that in Group RA (12/102, 11.8%) (p < 0.05). There was no significant difference in the incidence of adverse events, such as low SpO2, bradycardia, hypotension and body movement, between Groups RR and RA (p > 0.05).

Conclusions: Remimazolam-remifentanil causes less postoperative nausea and vomiting than remimazolam-alfentanil in hysteroscopy.

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编辑：Michel.米萱

校对：MiLu.米鹭

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