XUE Xiaoyun,XU Cheng,Han Xiaoli,et al.Effect of remimazolam with different doses on hemodynamic changes in elderly patients under general anesthesia[J].Journal of Tongji University(Medical Science),2023,44(4):574-579. [点击复制]
(Department of Anesthesiology, Shanghai Sixth People Hospital Haikou Orthopedic and Diabetics Hospital, Haikou 570311, China;Department of Anesthesiology, Shanghai Six People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China)
Abstract:
ObjectiveTo explore the effect of remimazolam with different doses on hemodynamic changes during general anaesthesia induction in elderly patients. MethodsOne hundred and twenty patients, aged 60-80 years with ASA Ⅰ-Ⅲ, who underwent elective surgery with laryngeal mask general anesthesia, were randomly divided into 4 groups: group P(given propofol 2mg/kg during induction, n=58), group R1(given remimazolam 0.2mg/kg, n=57), group R2(given remimazolam 0.3mg/kg, n=57) and group R3(given remimazolam 0.4mg/kg, n=58). All patients were sedated with remifentanil 0.5μg/kg/min at induction. The depth of intraoperative sedation was monitored with the electroencephalographic bifrequency index(BIS) and maintained at 40 to 60. The primary outcome was the incidence of hypotension(MAP<65mmHg) from the start of induction of anesthesia to 3 min after mask placement. Secondary outcomes included time from the start of remimazolam infusion to loss of consciousness(LOC), electroencephalographic BIS, MAP and heart rate variability within 5min of the start of induction. The occurrence of adverse events associated with the induction of anesthesia was recorded. ResultsThe incidence of hypotension was significantly lower in the group R1(26%) and group R2(32%) compared to the group P(55%)(P<0.05), while that was similar in the group R3(49%)(P>0.05). Compared to the group P, LOC was significantly prolonged in the groups R1, R2 and R3 after induction(P<0.05). The BIS values, MAP and heart rate were significantly higher in the groups R1 and R2 than those in groups P and R3 within 5min after induction(P<0.05). In addition, the rate of remedial sedation was significantly higher in the group R1 than that in the other three groups(P=0.002). There was no significant difference in the incidence of perioperative adverse events among 4 groups. ConclusionRemimazolam at dose of 0.2mg/kg or 0.3mg/kg can be used safely and effectively for the induction of mask general anaesthesia in elderly patients, while the remimazolam of 0.3mg/kg can maintain a more stable sedation effect.
