摘要
目的比较瑞马唑仑与丙泊酚用于儿童日间多生牙拔除术的有效性及安全性。方法选取江苏省口腔医院2022年10月—2023年4月于日间门诊全麻拔牙的患儿80例,采取随机数字表法分成丙泊酚组(P组)和瑞马唑仑组(R组),每组40例。丙泊酚组麻醉诱导丙泊酚2 mg/kg,麻醉维持丙泊酚6~12 mg/(kg·h),瑞芬太尼10μg/(kg·h)。瑞马唑仑组麻醉诱导瑞马唑仑0.3 mg/kg,麻醉维持瑞马唑仑0.8~1.5 mg/(kg·h),瑞芬太尼10μg/(kg·h)。记录两组患儿麻醉诱导前(T0)、插管前(T1)、插管后即刻(T2)、手术开始时(T3),手术结束时(T4),拔管即刻(T5),拔管后5 min(T6)的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)。记录组儿童手术时长、意识消失时间、拔管时间、镇静失败率等指标。结果R组T1-T4时刻MAP、HR高于P组(P<0.05)。R组意识消失时间长于P组(P<0.05),但拔管时间短于P组(P<0.05)。两组患儿的镇静成功率均为100%,但R组的补救镇静率明显高于P组(P<0.05)。不良事件R组总发生率2.50%,低于P组的47.5%(P<0.05)。两组患儿T0、T5、T6时刻MAP、HR水平,两组拔管后PAED评分无明显差异(P>0.05)。结论瑞马唑仑应用于儿童日间短小手术安全性及术后苏醒质量方面更具优势,可进一步临床推广应用。
Objective To compare the effectiveness,and safety of remazolam and propofol for supernumerary tooth extraction in oral day surgery on children.Methods Eighty patients who underwent tooth extraction in the Outpatient Department of Jiangsu Stomatological Hospital from October 2022 to April 2023 were selected and divided into propofol group(P group)and remazolam group(R group)by random number table,with 40 cases in each group.P group was given 2 mg/kg for anesthesia induction,maintained propofol 6-12 mg/(kg•h),remifentanil 10μg/(kg·h).R group was given 0.3 mg/kg for anesthesia induction,maintained remazolam 0.8-1.5 mg/(kg·h),remifentanil 10μg/(kg·h).HR and MAP were recorded before induction of anesthesia(T0),before endotracheal intubation(T1),after endotracheal intubation(T2),at the beginning of surgery(T3),at the end of surgery(T4),after extubation(T5),5 minutes after extubation(T6).The operation time,the time of consciousness disappearance,extubation time and sedation failure rate were recorded.Results Compared with group P,the MAP and HR of patients in group R increased significantly at T1 to T4(P<0.05);the time of consciousness disappearance was longer(P<0.05);the extubation time were shorter(P<0.05).The sedation success rate in both group was 100%.Compared with group P,remedial sedation rate in remazolam group was higher(P<0.05).Total incidence of major adverse events in group R(2.50%)was lower than that in group P(47.5%)(P<0.05).There was no significant difference in MAP and HR at T0,T5 and T6 between the two groups(P>0.05).There were no significant difference in PAED scores after awakening(P>0.05).Conclusion Remazolam has better anesthetic effect than propofol on supernumerary tooth extraction in oral day surgery on children,which has good clinical application value.
作者
余伊
孙强
茆梦
黄晨嘉
吴波
YU Yi;SUN Qiang;MAO Meng;HUANG Chenjia;WU Bo(Department of Anesthesiology,Jiangsu Key Laboratory of Oral Diseases,Nanjing Medical University/Affiliated Hospital of Stomatology,Nanjing Medical University,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine,Nanjing 210029,China)
出处
《口腔医学》
CAS
2023年第12期1076-1080,共5页
Stomatology
基金
江苏省科教能力提升工程——江苏省研究型医院(YJXYYJSDW4)
江苏省医学创新中心(CXZX202227)。
关键词
瑞马唑仑
丙泊酚
多生牙
日间手术
remazolam
propofol
supernumerary teeth
oral day surgery
