2025 年第 3 期 第 20 卷

瑞马唑仑与七氟烷对小儿腺样体肥大全身麻醉下日间手术术后躁动的影响比较

Comparison of the effects of remimazolam and sevoflurane on postoperative agitation in children with adenoid hypertrophy undergoing daytime surgery under general anesthesia

作者：王影王惠军陈红芽王古岩包音

英文作者：Wang Ying Wang Huijun Chen Hongya Wang Guyan Bao Yin

单位：首都医科大学附属北京同仁医院麻醉科，北京100730

英文单位：Department of Anesthesiology Beijing Tongren Hospital Capital Medical University Beijing 100730 China

关键词：腺样体切除；小儿；躁动；瑞马唑仑；七氟烷

英文关键词：Adenoidectomy;Children;Agitation;Remimazolam;Sevoflurane

• 摘要：

• 目的 探究瑞马唑仑与七氟烷对小儿腺样体肥大全身麻醉下日间腺样体切除手术术后躁动的影响，评估其在小儿全身麻醉中的应用效果。方法 选取2023年8—12月在首都医科大学附属北京同仁医院接受腺样体切除手术的腺样体肥大日间手术患儿50例。根据随机数字表法分为七氟烷组和瑞马唑仑组，每组25例。七氟烷组和瑞马唑仑组分别接受七氟烷和瑞马唑仑行麻醉维持。比较2组一般资料、术中情况、小儿麻醉苏醒期谵妄(PAED)量表评分、苏醒期躁动发生率、自主呼吸恢复时间、苏醒时间、拔管时间、术后疼痛强度、不良事件发生情况。结果 瑞马唑仑组拔管后5、10、20 min和出麻醉后监测治疗室时PAED量表评分均低于七氟烷组（均P<0.05）。瑞马唑仑组躁动发生率低于七氟烷组［12.0%（3/25）比44.0%（11/25）］(χ2=6.340，P=0.012)。瑞马唑仑组自主呼吸恢复时间、苏醒时间、拔管时间均短于七氟烷组（均P<0.05）。2组不良事件发生率比较差异无统计学意义（P=0.733）。2组拔管后5、10、20 min、出麻醉后监测治疗室时、拔管后6 h的疼痛强度比较差异均无统计学意义（均P>0.05）。结论 瑞马唑仑能有效降低小儿日间腺样体切除术后躁动的发生率，并能促进患儿术后康复。

• Objective  To explore the effects of remimazolam and sevoflurane on postoperative agitation after daytime adenoidectomy in children with adenoid hypertrophy under general anesthesia, and to evaluate their application effect in children undergoing general anesthesia. Methods A total of 50 children with adenoid hypertrophy who underwent daytime surgery in Beijing Tongren Hospital, Capital Medical University from August to December 2023 were selected. According to the random number table method, they were divided into sevoflurane group and remimazolam group, with 25 cases in each group. The sevoflurane group and remimazolam group received sevoflurane and remimazolam for maintenance of anesthesia, respectively. The general data, intraoperative conditions, pediatric anesthesia emergence delirium (PAED) scale score, incidence of agitation during recovery period, recovery time of spontaneous breathing, recovery time, extubation time, postoperative pain intensity, and adverse events were compared between the two groups. Results The scores of PAED scale at 5, 10, 20 min after extubation and at the time of leaving the postanesthesia care unit in the remimazolam group were lower than those in the sevoflurane group (all P<0.05). The incidence of agitation in remimazolam group was lower than that in sevoflurane group ［12.0%(3/25) vs 44.0%(11/25)］(χ2=6.340, P=0.012). The recovery time of spontaneous breathing, recovery time and extubation time in the remimazolam group were shorter than those in the sevoflurane group (all P<0.05). There was no significant difference in the incidence of adverse events between the two groups (P=0.733). There was no significant difference in pain intensity between the two groups at 5, 10, 20 min after extubation, at the time of leaving the postanesthesia care unit, and 6 h after extubation (all P>0.05). Conclusion Remimazolam can effectively reduce the incidence of postoperative agitation after daytime adenoidectomy in children, and can promote the postoperative rehabilitation of children.