Article(id=1291404554956951726, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291404554201985968, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2025.06.004, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1731340800000, receivedDateStr=2024-11-12, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785824439031, onlineDateStr=2026-08-04, pubDate=1743091200000, pubDateStr=2025-03-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785824439031, onlineIssueDateStr=2026-08-04, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785824439031, creator=13701087609, updateTime=1785824439031, updator=13701087609, issue=Issue{id=1291404554201985968, tenantId=1146029695717560320, journalId=1246415772164075586, year='2025', volume='41', issue='6', pageStart='751', pageEnd='900', issueExtLink='null', onlineDate='null', pubDate='1743091200000', pubDateStr='2025-03-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785824438858, creator='13701087609', updateTime=1785824438858, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=766, endPage=771, ext={EN=ArticleExt(id=1291404555598680239, articleId=1291404554956951726, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical trial of remimazolam for general anesthesia induction in vascular interventional treatment of intracranial aneurysms, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To observe the clinical efficacy and safety of general anesthesia induction with different doses of remimazolam in the vascular interventional treatment of intracranial aneurysms, and observe the safety.
Methods The patients with intracranial aneurysms who will receive vascular interventional treatment for intracranial aneurysms were divided into low-dose group (0.2 mg·kg-1 remimazolam), middle-dose group (0.3 mg·kg-1 remimazolam) and high-dose group (0.4 mg·kg-1 remimazolam) according to cohoert. The three groups completed intravenous injection of 0.2-0.4 mg·kg-1 remimazolam. When the consciousness of patients disappeared, 10 μg·kg-1 alfentanil and 0.2 mg·kg-1 cisatracurium besilate were used for anesthesia induction, and 0.3-1.0 mg·kg-1·h-1 remimazolam+ 0.1 μg·kg-1·min-1 remifentanil + 0.2 mg·kg-1·h-1 cisatracurium besilate were applied for anesthesia maintenance. The anesthetic effect, heart rate (HR) and mean arterial pressure (MAP) during recovery period, oxidative stress indexes at different time points and, remimazolam remedy were compared among the three groups, and the safety was evaluated.
Results There were 27 cases in low-dose group, 28 cases in middle-dose group and 25 cases in high-dose group. The HR values at extubation in low-dose group, middle-dose group and high-dose group were (79.47±6.85), (75.84±6.71) and (72.03±5.79) beat·min-1, HR values at 5 min after extubation were (81.92±6.59), (78.09±7.03) and (74.17±7.26) beat·min-1, serum superoxide dismutase (SOD) levels at 24 h after surgery were (87.61±11.25), (95.49±14.02) and (103.86±15.37) U·mL-1, serum malondialdehyde (MDA) levels were (19.69±2.74), (17.24±2.45) and (15.08±2.29) mmol·L-1, serum catalase (CAT) levels were (66.75±8.39), (71.69±8.55) and (76.91±9.13) U·mL-1, the onset time of sedation was (94.36±4.42), (82.29±4.15) and (75.17±5.38) s, respectively, and there were significant differences between any two groups of the three groups (all P<0.05). There were 4 cases (14.81%), 0 case and 0 case of remimazolam remedy in low-dose group, middle-dose group and high-dose group, respectively, and the index in middle-dose group and high-dose group was significantly different compared with that in low-dose group (P<0.05). In the low-dose group, there was 1 case (3.70%) of hypotension, 1 case (3.70%) of respiratory depression, and 2 cases (7.41%) of intraoperative body movement. In the middle-dose group, there was 1 case (3.70%) of hypotension, 1 case (3.57%) of bradycardia, and 1 case (3.70%) of respiratory depression. In the high-dose group, there was 1 case (4.00%) of hypotension, 2 cases (8.00%) of bradycardia, and 2 cases (8.00%) of respiratory depression. There was no statistically significant difference in the incidence of adverse drug reactions among the three groups (all P>0.05).
Conclusion The induction of general anesthesia with different doses of remimazolam has a certain application effect in the vascular interventional treatment of intracranial aneurysms, and the induction of general anesthesia with high doses of remimazolam (0.4 mg·kg-1) is the most ideal. It is not only beneficial to maintaining the stability of hemodynamics during the recovery period, and alleviating the oxidative stress response, but also shortening the onset time of sedation, reduce the number of remedial cases, and it has good safety.
, authors=Kuang XU, Bo CHEN, authorsList=Kuang XU, Bo CHEN, authorCompany=null, correspAuthors=Bo CHEN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1291404555963584688, articleId=1291404554956951726, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=瑞马唑仑全麻诱导在颅内动脉瘤患者血管介入治疗中的临床研究, columnId=1246531407485489349, journalTitle=中国临床药理学杂志, columnName=临床与基础桥接研究, runingTitle=null, highlight=null, articleAbstract=
目的 观察不同剂量瑞马唑仑全麻诱导在颅内动脉瘤血管介入治疗中的临床疗效及安全性。
方法 将接受颅内动脉瘤血管介入治疗的颅内动脉瘤患者按队列法分为低剂量组（0.2 mg·kg-1瑞马唑仑）、中剂量组（0.3 mg·kg-1瑞马唑仑）和高剂量组（0.4 mg·kg-1瑞马唑仑）。3组患者静脉注射0.2~0.4 mg·kg-1瑞马唑仑，待意识消失后，同时给予10 μg·kg-1阿芬太尼、0.2 mg·kg-1苯磺顺阿曲库铵诱导麻醉，并给予0.3～1.0 mg·kg-1·h-1瑞马唑仑+0.1 μg·kg-1·min-1瑞芬太尼+0.2 mg·kg-1·h-1苯磺顺阿曲库铵维持麻醉。比较3组患者的麻醉效果、苏醒期心率（HR）和平均动脉压（MAP）、不同时间点氧化应激指标、瑞马唑仑补救情况，并评价安全性。
结果 低剂量组27例、中剂量组28例和高剂量组25例。低剂量组、中剂量组和高剂量组拔管时的HR分别为（79.47±6.85）、（75.84±6.71）和（72.03±5.79）beat·min-1，拔管后5 min的HR分别为（81.92±6.59）、（78.09±7.03）和（74.17±7.26）beat·min-1，术后24 h的血清超氧化物歧化酶（SOD）水平分别为（87.61±11.25）、（95.49±14.02）和（103.86±15.37）U·mL-1，血清丙二醛（MDA）水平分别为（19.69±2.74）、（17.24±2.45）和（15.08±2.29）mmol·L-1，血清过氧化氢酶（CAT）水平分别为（66.75±8.39）、（71.69±8.55）和（76.91±9.13）U·mL-1，镇静起效时间分别为（94.36±4.42）、（82.29±4.15）和（75.17±5.38）s，3组患者的以上指标两两比较，在统计学上差异均有统计学意义（均P<0.05）。低剂量组、中剂量组和高剂量组瑞马唑仑补救例数分别为4例（14.81%）、0例和0例，中剂量组和高剂量组的以上指标与低剂量组比较，在统计学上差异均有统计学意义（均P<0.05）。低剂量组出现1例（3.70%）低血压，1例（3.70%）呼吸抑制，2例（7.41%）术中体动；中剂量组出现1例（3.70%）低血压，1例（3.57%）心动过缓，1例（3.70%）呼吸抑制；高剂量组出现1例（4.00%）低血压，2例（8.00%）心动过缓，2例（8.00%）呼吸抑制。3组药物不良反应发生率比较，差异均无统计学意义（均P>0.05）。
结论 不同剂量瑞马唑仑全麻诱导在颅内动脉瘤血管介入治疗中均具有一定的应用效果，且高剂量（0.4 mg·kg-1）瑞马唑仑全麻诱导的作用最理想，不仅有利于维持苏醒期血流动力学的稳定，缓解氧化应激反应，还可缩短镇静起效时间，减少补救例数，安全性良好。
, authors=徐旷, 陈波, authorsList=徐旷, 陈波, authorCompany=null, correspAuthors=陈波, authorNote=
徐旷（1987-），男，主治医师，主要从事临床麻醉方面的工作
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