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| Efficacy of Remimazolam for induction and maintenance of general anesthesia with laryngeal mask in patients undergoing otorhinolaryngology surgery |
| WANG Huijun1 XIONG Jun2 BAO Yin1 XI Chunhua1 WANG Guyan1 |
1.Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;
2.Department of Anesthesiology, Shenzhen University General Hospital, Guangdong Province, Shenzhen 518055, China |
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Abstract Objective To evaluate the efficacy of Remimazolam for induction and maintenance of laryngeal mask general anesthesia in patients undergoing otorhinolaryngology surgery, and to explore a new general anesthesia model that can be safely used in day surgery. Methods A total of 114 patients of undergoing otorhinolaryngology surgery under laryngeal mask general anesthesia admitted to Beijing Tongren Hospital from April 2021 to February 2022. They were divided into Propofol group and Remimazolam group using a random number table method, with 57 cases in each group. At the beginning of induction, intravenously infusing Sufentanil 0.2 μg/kg, Propofol 2 mg/kg was injected in Propofol group, Remimazolam 0.3 mg/kg was injected in Remimazolam group, Rocuronium 0.6 mg/kg was injected after the patients consciousness disappeared, laryngeal mask intubation was performed. Anesthesia was maintained by intravenously injecting Propofol 4-8 mg/(kg·h) in Propofol group and Remimazolam 1-3 mg/(kg·h) in Remimazolam group. Bispectralindexvalues (BIS) was maintained at 40-60. The time of sedation induction, recovery time of consciousness, time of laryngeal mask extubation and residence time in postanesthesia care unit (PACU) were recorded; the MAP and HR before induction(T0), before laryngeal mask implantation (T1), after laryngeal mask implantation (T2), before surgery (T3), at drug withdrawal(T4) and at laryngeal mask removal (T5) were recorded; the occurrence of injection pain during induction of anesthesia, intraoperative and postoperative complications were recorded. Results The success rate of sedation in both groups was 100%. The sedation induction time of Remimazolam group was higher than that of Propofol group, and the incidence of injection pain, intraoperative hypotension, and bradycardia during induction was lower than that of Propofol group, and the differences were statistically significant (P ＜ 0.05); there was no significant difference in consciousness recovery time, laryngeal mask removal time, PACU residence time, postoperative tachycardia, and postoperative nausea and vomiting between the two groups (P ＞ 0.05). There was no significant difference in MAP between the two groups at T0 (P ＞ 0.05); the MAP value of T1-T5 in both groups was lower than that of T0, but that of Remimazolam group was higher than that of Propofol group, and the differences were statistically significant (P ＜ 0.05); there was no significant difference in HR between the two groups at T0 (P ＞ 0.05); the HR values at T1 and T5 in Remimazolam group were higher than those in Propofol group, and the difference was statistically significant (P ＜ 0.05); the HR value of Propofol group at T1-T4 was lower than that at T0, and the difference was statistically significant (P ＜ 0.05); there was no significant difference between the HR values at T1, T2, T5, and T0 in Remimazolam group (P ＞ 0.05); no intraoperative hypertension and intraoperative awareness were found in both groups. No other complications were found during in PACU and within 24 h after operation. Conclusion Remimazolam can be safely and effectively used in the induction and maintenance of laryngeal mask general anesthesia in otorhinolaryngology surgery, which is more helpful to maintain the stability of hemodynamics and reduce the incidence of adverse reactions.
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