To Study The Safety And Efficacy Of Remazolam Combined With Dexamethasone For Prevention Of Postoperative Nausea And Vomiting After Short Laparoscopic Surgery

PurposeTo evaluate the efficacy and safety of Remazolam combined with dexamethasone versus dexamethasone alone in the prevention of nausea and vomiting after short laparoscopic surgery..MethodsA total of 120 patients,aged 18-60 years,ASA class I or II,BMI 18-30 kg/m2,undergoing Small general surgery laparoscopic at the Central Hospital of XXX from July 2022 to January 2023 were selected.They were randomly divided into control group(group C),low-dose group(group S),medium-dose group(group M)and high-dose group(group L).At the beginning of anesthesia,appropriate doses of remimazolam or normal saline were administered,followed by sedation,analgesia and muscle relaxants.The primary outcome:The number of PONV occurrences 6hours,6-24 hours,and 24 hours after surgery.Secondary Indicators:intraoperative and postoperative adverse events,gender,age,BMI,surgical category,ASA classification.ResultsA total of 120 patients participated in this trial,All patients signed informed consent for the use of remimazolam.Finally,30 patients in C group、30 patients in S group、30 patients in M group and 30 patients in L group participated in the trial.1.There were no significant differences in ASA classification,BMI,gender,age,underlying diseases and Intraoperative opioid use among the four groups(P >0.05).2.Intraoperative opioid use within 0-6h after surgery,the incidence of postoperative PONV in each group was statistically significant(P<0.05).3.There was no statistical significance in the incidence of PONV between group C and group S(P>0.05).4.The incidence of PONV in group C and group M within 0-6h after surgery was statistically significant(P<0.05).5.The incidence of PONV in group C and group L within 0-6h and 24 h after surgery was statistically significant(P<0.05).6.The incidence of POV in group C was statistically significant in 0-6h,6-24 hours and 24 hours after surgery compared with group L(P<0.05).7.The incidence of PON in group C and group L within 0-6h and 24 hours after surgery was statistically significant(P<0.05).8.The use of antiemetic drugs within 24 hours after surgery was statistically significant in the four groups(P<0.05).9.There was one case of intractable hiccup and one case of suspected hypersensitivity after induction at experimental dose.No irreversible injury was caused and no other adverse reactions occurred.ConclusionThe use of 0.2-0.25mg/kg remimazolam combined with dexamethasone during anesthesia induction can effectively reduce the incidence and severity of PONV within 6 hours after surgery,and 0.25mg/kg remimazolam combined with dexamethasone can reduce the incidence and severity of PONV within 24 hours after surgery.At the same time,0.2-0.25mg/kg remimazolam combined with dexamethasone can reduce the use of postoperative rescue antiemetic drugs,and remimazolam is safe in this dose range.