Effect of remimazolam on intraoperative neurophysiological monitoring in spinal surgery
10.12089/jca.2023.12.005
- VernacularTitle:瑞马唑仑对脊柱手术中神经电生理监测的影响
- Author:
Yan FANG
1
;
Shiping YIN
;
Wenjie SUN
Author Information
1. 341099 赣州市人民医院麻醉科
- Keywords:
Remimazolam;
Propofol;
Neurophysiological monitoring;
Spinal surgery
- From:
The Journal of Clinical Anesthesiology
2023;39(12):1260-1264
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of remimazolam on intraoperative neurophysiological monitoring(IONM)in spinal surgery.Methods Sixty patients undergoing elective spinal surgery for IONM were selected strictly according to the criteria,33 males and 27 females,aged 18-55 years,BMI 18-24 kg/m2,ASA physical status Ⅰ-Ⅲ.The patients were randomly divided into two groups:remimazolam group(group R)and propofol group(group P),30 patients in each group.Remimazolam was used in group R and propofol was used in group P during induction and maintenance of anesthesia.HR,MAP,and BIS values were recorded when patients entered the room(T0),immediately after endotracheal intubation(T1),at the time of muscle relaxant withdrawal(T2),30 minutes after muscle relaxant withdrawal(T3),and 50 minutes after muscle relaxant withdrawal(T4).The current intensity and amplitude of the first motor evoked potential(MEP)were recorded.The waiting time from drug withdrawal to the first induced MEP was recorded.The amplitude and latency of somatosensory evoked potential(SEP)and MEP at T4 were recorded.Operation time,anesthesia time,intraoperative remifentanil dosage,the use of vasoactive drugs,recovery time,extubation time,and adverse reactions were recorded.Results Compared with group P,HR and MAP were significantly increased at T1-T4(P＜0.05),the amplitude of MEP induced for the first time were significantly increased(P＜0.05),the amplitudes of SEP and MEP at T4 were significantly in-creased and the latency period was significantly shortened(P＜0.05),the dosage of remifentanil was sig-nificantly decreased(P＜0.05),the number of bradycardia or hypotension were significantly decreased(P＜0.05),and the recovery time and extubation time were significantly shortened in group R(P＜0.05).Conclusion Remimazolam can be safely used in spinal surgery requiring IONM,with small circu-lation fluctuation,quick recovery,less postoperative adverse reactions,little effect on SEP and MEP,which is conducive to improving the quality of IONM.
