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| Sedation and analgesia effect of the different doses of remrazolam used during hysteroscopic surgery of patients |
| Affiliated Hospital of West Anhui Health Vocational College, Lu'an, Anhui Province, 237000 |
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Abstract To explore the effect of the different doses of remrazolam for sedation and analgesia during hysteroscopic surgery of patients, and to study the differences of the adverse reactions of the patients. Methods: 90 patients who wanted hysteroscopic surgery in the obstetrics and gynecology department of the hospital were randomly divided into three groups (30 cases in each group) from September 2020 to July 2022. All the patients in the three groups were given sufentanil 0.2μg/kg and remimazolam 0.2mg/kg for anesthesia induction, and then the patients in group A, in group B and in group C were given 0.5mg/kg/h, 1.0mg/kg/h, and 1.5mg/kg/h remimazolam for anesthesia maintained, respectively. The values of anesthesia indicators, such as anesthesia onset time and awakening time, the values of sedation effect, such as BIS control time and BIS value, the levels of stress response indicators, such as Cortisol (Cor), C -reactive protein (CRP) and interleukin 6 (IL-6), and the rates of the rescue analgesia and restlessness during awakening, and the rate of adverse reactions, such as intraoperative physical activity, respiratory depression, nausea and vomiting and hypotension of the patients in three groups were observed. Results: There was no significant difference in the anesthesia on-set time of the patients among the three groups (P>0.05). The awaking time of the patients in group B (557.26±141.47 s) or in group in C (550.25±139.93 s) was significantly longer than that (388.34±103.34 s) of the patients in group A (all P<0.05). There was no significant difference in the BIS value of the patients among the three groups (P<0.05). The BIS control time of the patients in group C (48.93±81.15 s), in group B (63.64±9.11 s), and in group A (75.52±12.24 s) had increased gradually (P<0.05). The levels of serum Cor, CRP and IL-6 of the patients in group B and in group C were significantly lower than those of the patients in group A. The incidence of rescue analgesia of the patients in group B and group C (16.7% and 13.3%) and the incidence of agitation during awaking of the patients in group B and group C (10.0% and 6.7%) were significantly lower than those (43.3% and 33.3%) of the patients in group A (all P<0.05). There was no significant difference in the incidence of the adverse reactions (26.7% vs. 20.0% vs. 16.7%) of the patients among the three groups (P>0.05). Conclusion: There are differences in the application effect of the different doses of remrazolam for the anesthesia maintenance during hysteroscopic surgery of the patients. 1.0mg/kg/h remrazolam used for anesthesia maintenance can meet the surgical requirement, which has better sedative and analgesic effect, and has mild stress reactions of the patients, with fewer adverse reactions.
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