关键词: 瑞马唑仑；全麻诱导；结肠癌根治术；应激反应；血流动力学

Abstract: Objective To explore the influence of different doses of remimazolam for general anesthesia induction on tracheal intubation stress response and hemodynamics in patients undergoing radical resection of colon cancer.Methods From August 2020 to August 2023, 75 patients undergoing radical resection of colon cancer were induced by general anesthesia using remazolam.According to the random number table method,they were divided into group A (25 cases,0.2 mg/kg of remimazolam),group B (25 cases,0.3 mg/kg of remimazolam) and group C (25 cases,0.4 mg/kg of remimazolam).The stress response status [cortisol (Cor),epinephrine (E),norepinephrine (NE)] and hemodynamics [heart rate (HR),mean arterial pressure (MAP)] before anesthesia (T0),at tracheal intubation (T1),at 30 min after intubation (T2) and at 10 min after extubation (T3),anesthesia recovery status and total incidence rate of adverse anesthesia reactions were compared among the three groups.Results At T0,there were no obvious differences in the levels of Cor,E,NE,HR,SVI and MAP among the three groups (P>0.05).At T1-T3,the levels of Cor,E and NE in group A [T1:(181.76±12.49) pg/ml,(67.94±2.66) ng/ml,(355.12±19.82) ng/ml;(231.90±15.82) pg/ml,(72.15±2.83) ng/ml,(379.86±20.31) ng/ml;T3:(300.65±17.43) pg/ml,(77.82±2.85) ng/ml,(405.31±24.36) ng/ml] were higher than those in group B [T1:(172.31±12.07) pg/ml,(66.22±2.73) ng/ml,(326.47±19.24) ng/ml;T2:(214.75±14.88) pg/ml,(70.34±2.79) ng/ml,(354.18±20.66) ng/ml;T3:(279.08±16.62) pg/ml,(75.03±2.81) ng/ml,(387.05±22.82) ng/ml] and group C [T1:(165.44±11.74) pg/ml,(64.01±2.75) ng/ml,(300.66±19.50) ng/ml;T2:(200.42±14.35) pg/ml,(67.59±2.80) ng/ml,(330.18±21.05) ng/ml;T3:(251.33±16.08) pg/ml,(72.44±2.70) ng/ml,(354.11±22.07) ng/ml] (P＜0.05).At T1-T2,the HR and MAP were higher in group A [T1:(79.49±4.05) beats/min,(96.09±1.77) mmHg;T2:(76.55±3.83) beats/min,(94.88±1.55) mmHg] than those in group B [T1:(76.22±3.89) beats/min,(95.01±1.63) mmHg;T2:(74.23±3.76) beats/min,(93.89±1.51) mmHg] and group C [T1:(73.65±3.81) beats/min,(94.02±1.61) mmHg;T2:(71.55±3.61) beats/min,(92.97±1.46) mmHg] (P＜0.05).There were no significant differences in HR and MAP among the three groups at T3 (P>0.05).The time of breathing recovery,open eye and extubation in group C was significantly longer compared with that in group A and group B (P＜0.05).There were no significant difference in total incidence rate of anesthesia adverse reactions between group B and group A,group C(P>0.05).Conclusion 0.3 mg/kg remimazolam in patients undergoing radical resection of colon cancer has an ideal sedative effect,and it has small impact on stress response and hemodynamics,and has fast postoperative recovery and high safety.

Key words: remimazolam;general anesthesia induction;radical resection of colon cancer;stress response;hemodynamics