| Background:Since propofol was launched on the market,it has been widely usedin the induction and maintenance of clinical anesthesia due to its advantages of fast onset of action,fast metabolism,and no obvious accumulation,but its inhibition on thecirculatory system and respiratory system increases with the dose,reaching the requird depth of sedation usually causes adverse reactions such as hypotension and heart rate drop,and vasopressor drugs need to be given to maintain blood pressure,and there is obvious injection pain and discomfort for the patient.Etomidate has little effect on cardiovascular system.It is suitable for elderly patients or patients with basic cardiovascular diseases.However,etomidate has adverse effects such as inhibiting adrenal cortex and muscle fibrillation.In recent years,new drugs frequently appeared in 2020.Compared with propofol,remimazolam besylate and ciprofol have less influence on circulatory system and respiratory system,but its clinical application time in China is short,and the related clinical research and data are limited.It is necessary to further study it.Objective: The purpose of this study was to compare the effects of remimazolam besylate,ciprofol and propofol on circulatory system during induction of general anesthesia,and to provide theoretical basis for better clinical application of remimazolam besylate.Method:A total of 60 patients who needed general anesthesia and tracheal intubation for elective surgery in the Affiliated Hospital of Changchun University of Chinese Medicine from July 2022 to November 2022 were selected and randomly divided into 3 groups,20 cases in the propofol group(group P)20 cases in the ciprofol group(Group H)and 20 cases in the remimazolam besylate group(Group R).During anesthesia induction,the three groups were given anesthesia sedatives propofol 2mg/kg,ciprofol 0.4mg/kg,remimazolam besylate0.3 mg/kg intravenous injection,when BIS<60,give cisatracurium 2 mg/kg,sufentanil 0.4ug/kg,complete the tracheal laryngoscopy after complete muscle relaxation Intubated and mechanically ventilated.Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SPO2)and bispectral index(BIS)were recorded at three time points before administration(T1)and 2min after administration(T2)and after endotracheal tube fixation(T3).The difference of data at each time point was calculated to measure the anesthesia depth and its influence on hemodynamics,and the injection pain was recorded.Inquiring whether there was intraoperative knowledge and other adverse events occurred SPSS 21.0 was used for statistics.Result:The mean arterial pressure of Group P was significantly lower than that of Group H and Group R(p> 0.05).The mean arterial pressure of Group R was higher than that of Group H and Group R at 2min after intubation,but not significantly higher than that before administration.Heart rate was decreased in all three groups(p> 0.05).Intubation could increase heart rate in R group,but there was no significant difference between them before administration.Bispectral index of EEG decreased in all three groups.but at T2T3 time point,bispectral index of EEG in R group was higher than that in P group and H group.Incidence rate of awareness of salvage hypertensive tachycardia during induction in all three groups was 0%(p>0.05),and t-here was no significant difference(p>0.05).The incidence of hypotensive injection pain in Group P was significantly higher than that in the other two groups(p<0.05).The incidence of bradycardia in Group P and H was equal and significantly higher than that in Group R(p<0.05).The incidence of hypotensive injection pain in Group H was significantly higher than that in Group R(p<0.05).Conclusion:The effects of ciprofol and remimazolam besylate on blood pressure during induction of general anesthesia were significantly less than those of propofol.It were not significantly different on heart rate and bispectral index of EEG during induction of general anesthesia.The incidence of adverse reactions such as ciprofol and remimazolam besylate hypotension,bradycardia and injection pain was also lower than that of propofol.Compared with remimazolam besylate,the decrease of blood pressure and heart rate after administration of ciprofol was similar,but the incidence of bradycardia of ciprofol was higher than that of remimazolam besylate. |
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