Effect of remimazolam preoperative sedation on emergence delirium in children undergoing tonsillectomy and/or adenoidectomy
10.12206/j.issn.2097-2024.202411036
- VernacularTitle:瑞马唑仑术前镇静对扁桃体或腺样体切除患儿苏醒期谵妄的影响
- Author:
Fei WANG
1
;
Rui ZHANG
1
;
Yong XU
1
;
Xian CHEN
2
;
Yumin ZHU
3
Author Information
1. Department of Anesthesia, Zhongshan Hospital of Xiamen University, Xiamen 361004, China.
2. Department of Anesthesia, The First Affiliated Hospital of Suzhou University, Suzhou 215006, China.
3. Department of Anesthesia, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215000, China.
- Publication Type:Medicine&Clinical
- Keywords:
remimazolam;
emergence delirium;
pediatric;
preoperative sedation
- From:
Journal of Pharmaceutical Practice and Service
2026;44(8):426-430
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of remimazolam premedication on emergence delirium （ED） in children undergoing tonsillectomy and/or adenoidectomy. Methods Children aged 3-6 years who underwent tonsillectomy and/or adenoidectomy with general anesthesia in Zhongshan Hospital Affiliated to Xiamen University from July 2023 to September 2024 were randomly divided into 0.1 mg/kg remimazolam group （group R1）, 0.2 mg/kg remimazolam group group R2） and normal saline group （group P）. Three groups were sedated preoperatively with remimazolam 0.1 mg/kg, remimazolam 0.2 mg/kg and normal saline, respectively. The primary outcome was the incidence of ED. The secondary outcomes included the parental separation anxiety scale （PSAS） score when entering the operating room, the induction compliance checklist （ICC） score at induction, the anesthetic recovery time, the incidence of rescue propofol for ED, the face, legs, activity, cry, and consolability （FLACC） score and the incidence of postoperative pain during the recovery period, the incidence of adverse reactions during the operation and postoperatively, and the incidence of negative postoperative behavioral changes （NPOBCs） at first day, 7th day, 30th day postoperatively. Results A total of 119 children completed the study, including 41 children in group R1, 38 children in group R2, and 40 children ingroup P. The incidence of ED and propofol rescue, the PSAS scores and ICC scores of group R1 and R2 were lower than that of group P （P<0.05）, and the above results in group R2 was better than those in group R1 （P<0.05）. The FLACC score, the incidence of postoperative pain, and the incidence of adverse reactions among the three groups had no difference （P>0.05）. The incidence of NPOBCs at 1st day and 7th day postoperatively in group R1 and group R2 was lower than that in group P （P<0.05）, but no difference was detected at 30th day postoperatively among the three groups （P>0.05）. Conclusion Remimazolam used for preoperative sedation could reduce the incidence of ED in children undergoing tonsillectomy and/or adenoidectomy, and had a positive effect on alleviating the preoperative anxiety and preventing NPOBCs.
