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与吸入麻醉剂相比，瑞马唑仑对鼻内镜手术患者术中低温发生率的影响：一项前瞻性随机对照试验
贵州医科大学 麻醉与心脏电生理课题组
翻译：田明德 编辑：田明德 审校：曹莹
背景：瑞马唑仑是一种超短效苯二氮卓类药物，越来越多地用于麻醉诱导和维持。然而，与传统吸入麻醉剂相比，其对术中低温的影响研究有限。本研究旨在比较鼻内窥镜手术中使用瑞马唑仑维持麻醉与使用吸入麻醉剂时低温的发生率。
方法：这项前瞻性研究包括70例在全身麻醉下接受鼻内窥镜手术的患者。患者被随机分为两组：吸入性麻醉（IA）组（n=35），给予地氟醚和氧化亚氮；瑞马唑仑(R)组（n=35），给予瑞马唑仑和瑞芬太尼维持麻醉。主要观察指标是术中低温的发生率，定义为麻醉期间食道温度低于36°C。
结果：R组术中低温发生率明显高于IA组（P = 0.014）。R组手术结束时体温明显低于IA组（P = 0.006）。此外，R组术后使用暖化装置的频率高于IA组（P = 0.047）。
结论：这些研究结果表明，与使用吸入麻醉剂相比，在鼻内窥镜手术中使用瑞马唑仑维持麻醉会增加术中低温的风险。这突出了在接受瑞马唑仑治疗的患者中进行体温监测的重要性，以尽量减少手术期间与低温相关的不良后果。
原始文献来源：Cho SA, Lee SJ, Kwon W, et al. Effect of Remimazolam on the Incidence of Intraoperative Hypothermia Compared with Inhalation Anesthetics in Patients Undergoing Endoscopic Nasal Surgery: A Prospective Randomized Controlled Trial. Int J Med Sci. 2024;21(13):2510-2517. Published 2024 Sep 30.
Effect of Remimazolam on the Incidence of Intraoperative Hypothermia Compared with Inhalation Anesthetics in Patients Undergoing Endoscopic Nasal Surgery: A Prospective Randomized Controlled Trial
Abstract
Background: Remimazolam is an ultrashort-acting benzodiazepine that is increasingly used for its efficacy in anesthesia induction and maintenance. However, limited research has explored its impact on intraoperative hypothermia compared to that of traditional inhalation anesthetics. This study aimed to compare the incidence of hypothermia during endoscopic nasal surgery when using remimazolam for maintenance anesthesia versus using inhalation anesthetics.
Method:This prospective study included 70 patients who underwent endoscopic nasal surgery under general anesthesia. The patients were randomly assigned to one of two groups: the inhalation anesthetic (IA) group (n=35), in which desflurane and nitrous oxide were administered, and the remimazolam (R) group (n=35), in which remimazolam and remifentanil were administered for anesthesia maintenance. The primary outcome was the incidence of intraoperative hypothermia, defined as an esophageal temperature below 36 °C during anesthesia.
Results:The incidence of intraoperative hypothermia was significantly higher in the R group than in the IA group (P = 0.014). Furthermore, the temperature at the end of the surgery was significantly lower in the R group than in the IA group (P = 0.006). Additionally, the use of warming devices after surgery was more frequent in the R group than in the IA group (P = 0.047).
Conclusion:These findings suggest that the use of remimazolam for maintenance anesthesia during endoscopic nasal surgery increases the risk of intraoperative hypothermia compared to the use of inhalation anesthetics. This highlights the importance of temperature monitoring in patients receiving remimazolam to minimize the adverse outcomes associated with hypothermia during surgery.
