Remimazolam Requires Less Vasopressor Support during Induction and Maintenance of General Anesthesia in Patients with Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement: A Retrospective Analysis from a Single Center.
Remimazolam Requires Less Vasopressor Support during Induction and Maintenance of General Anesthesia in Patients with Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement: A Retrospective Analysis from a Single Center.
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DOI：
10.1155/2022/6386606
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发表时间：
2022
影响因子：
--
通讯作者：
Tsutsumi, Yasuo M.
中科院分区：
文献类型：
--
作者：
Miyoshi, Hirotsugu;Watanabe, Tomoyuki;Kido, Kenshiro;Kamiya, Satoshi;Otsuki, Sachiko;Narasaki, Soshi;Toyota, Yukari;Kondo, Takashi;Horikawa, Yousuke T.;Saeki, Noboru;Tsutsumi, Yasuo M.
我们比较了雷马唑仑全身麻醉和常规麻醉对严重主动脉瓣狭窄（AS）患者血流动力学的影响。这是一项回顾性单中心分析。我们回顾了2020年1月至12月在全身麻醉下经股动脉入路经导管主动脉瓣植入术的42例患者的记录。根据全麻（诱导/维持）使用雷马唑仑/雷马唑仑（R/R组）、异丙酚/七氟醚（P/S组）、咪达唑仑/异丙酚（M/P组）分为3组。比较各组间血管加压素（麻黄碱、苯肾上腺素和去甲肾上腺素）的使用情况。两组患者人数分别为R/R组15例、P/S组13例、M/P组14例，背景特征及术中生命体征差异无统计学意义。麻醉诱导时，R/R组麻黄碱和苯肾上腺素的使用剂量明显低于R/R组（麻黄碱[mg]: R/R 2组[0 - 4]vs P/S 8组[8 - 12]，P < 0.001， R/R组vs M/P 5组[0 - 15]，P = 0.39；苯肾上腺素（mg）： R/R 0组[0 - 0.08]vs P/S 0.15组[0.10-0.20],P = 0.03, M/P 0.21组[0.04-0.40],P = 0.08）。在麻醉维持方面，R/R组去甲肾上腺素用量较低（去甲肾上腺素[μg/kg/min]: R/R组0.019 [0.015-0.039],P/S 0.042 [0.035-0.045], P = 0.02, M/P 0.048 [0.040-0.059], P < 0.01）。在严重AS患者中，诱导和维持雷马唑仑麻醉导致总体血管加压药的使用少于常规全身麻醉剂。
We compared the hemodynamics during general anesthesia with remimazolam and conventional anesthetics in patients with severe aortic stenosis (AS). This was a retrospective single-center analysis. We reviewed the records of 42 patients who underwent transcatheter aortic valve implantation with a transfemoral artery approach under general anesthesia from January to December 2020. Patients were divided into three groups based on the general anesthetic used for (induction/maintenance) remimazolam/remimazolam (Group R/R), propofol/sevoflurane (Group P/S), and midazolam/propofol (Group M/P). Vasopressor use (ephedrine, phenylephrine, and noradrenaline) was compared among the groups. The number of patients in each group was 15 (Group R/R), 13 (Group P/S), and 14 (Group M/P), with no significant difference in background characteristics and intraoperative vital signs. For anesthesia induction, doses of ephedrine and phenylephrine used were significantly lower in Group R/R (ephedrine [mg]: Group R/R 2 [0–4] vs. Group P/S 8 [8–12], P < 0.001, Group R/R vs. Group M/P 5 [0–15], P = 0.39; phenylephrine (mg): Group R/R 0 [0–0.08] vs. Group P/S 0.15 [0.10–0.20], P = 0.03, Group M/P 0.21 [0.04–0.40], P = 0.08). For anesthesia maintenance, the noradrenaline dose used was low in the Group R/R (noradrenaline [μg/kg/min]: Group R/R 0.019 [0.015–0.039], Group P/S 0.042 [0.035–0.045], P = 0.02, Group M/P 0.048 [0.040–0.059], P < 0.01). In patients with severe AS, induction and maintenance of anesthesia with remimazolam resulted in less overall vasopressor use than conventional general anesthetics.
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影响因子：
8.8
作者：
Ibrahim, AE;Taraday, JK;Kharasch, ED
通讯作者：
Kharasch, ED
影响因子：
2.8
作者：
Doi, Matsuyuki;Morita, Kiyoshi;Suzuki, Toshiyasu
通讯作者：
Suzuki, Toshiyasu
DOI：
10.1046/j.1365-2125.1997.t01-1-00612.x
发表时间：
1997-11-01
影响因子：
3.4
作者：
Dingemanse, J;vanGerven, JMA;Cohen, AF
通讯作者：
Cohen, AF
影响因子：
8.8
作者：
Hiltebrand, Luzius B.;Koepfli, Eliana;Brandt, Sebastian
通讯作者：
Brandt, Sebastian
影响因子：
8.8
作者：
Kilpatrick, Gavin J.;McIntyre, Margaret S.;Tilbrook, Gary S.
通讯作者：
Tilbrook, Gary S.