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To evaluate the anesthetic effects of remimazolam in total intravenous anesthesia (TIVA) patients undergoing radical thyroidectomy.
Patients aged 18~65 with ASA physical status Ⅰ~Ⅱ were scheduled for radical thyroidectomy under TIVA. The current study consisted of two parts. Part Ⅰ: The anesthetic induction dose of remimazolam was determined using modified Dixon's up-and-down method. Part Ⅱ: The effect of remimazolam in anesthetic maintenance of TIVA was evaluated. The patients were randomly divided into two groups, propofol as control P group and remimazolam as experimental R group. After endotracheal intubation, propofol or remimazolam was continuously infused under TIVA to complete surgery. The onset time, intubation time, drug consumption and hemodynamics at certain time points were analyzed. In addition, the awakening time and adverse effects were also compared. The cognitive functions were evaluated by scale of MMSE and MoCA.
The anesthetic induction doses of propofol and remimazolam were 1.76 mg·kg-1 and 0.43 mg·kg-1 respectively. The onset time of the two groups had no significant difference (P>0.05). However, the intubation time of remimazolam group (103.23±9.14) s was significantly increased than that of the control group (86.58±8.32) s (P<0.05). The mean pump speed of remimazolam was 1.12 mg·kg-1·h-1 in TIVA. The hemodynamics of remimazolam group [MAP: (88.2±8.4) mmHg; HR: (74.2±7.1) per minute] was more stable than that of the control group [MAP: (77.9±7.4) mmHg; HR: (68.8±6.5) per minute] (P<0.05). The awakening time of remimazolam group (19.31±4.26) min was enhanced compared with the control group (13.86±3.65) min (P<0.05). The adverse effects and cognitive functions of the two groups had no statistical differences (P>0.05).
Remimazolam is safe for clinical anesthetic induction and intraoperative maintenance undergoing radical thyroidectomy, and the hemodynamics is more stable in TIVA.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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