Observation on the application of Remimazolam combined with Nalbuphine anesthesia in the extraction of supernumeric teeth in children

LI Nan; ZHANG Qin; YAN Yuqiang; ZHANG Weitao; SU Rui

doi:10.3969/j.issn.1002-3429.2025.17.016

Abstract：Objective To explore the application effect of Remazolam combined with Nalbuphine anesthesia in the extraction of supernumerary teeth in children.Methods A total of 98 children who underwent supernumerary tooth extraction from August 2021 to August 2024 were selected and divided into the observation group and the control group by random number table method,with 49 patients in each group.The observation group was anesthetized with Remazolam combined with Nalbuphine,while the control group was anesthetized with Remazolam.The operation indexes,hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),blood oxygen saturation(SpO2)before anesthesia induction(T0),before intubation(T1),immediately after intubation(T2),at the initation of surgery(T3),at the end of surgery(T4),immediately after extubation(T5),at 5 min after extubation(T6)],anesthesia recovery quality[Children's and Infants,Postoperative Pain Scale(CHIPPS)score at 10,20,30 min after recovery,Pediatric Anesthesia Emergence Delirium(PAED)score]and perioperative adverse reactions were compared between the two groups.Results The disappearance time of consciousness in the observation group was shorter than that in the control group(P<0.01).The HR and MAP at T1,T3 and T4 in the observation group were higher than those in the control group,the RR at T1 and T3 were lower than those in the control group,and the RR at T4 was higher than that in the control group(P<0.05).There was almost no fluctuation of SpO2 at T0-T6 in the two groups(P>0.05).The changes in MAP,RR and HR at T1-T6 in the observation group were smaller than those at T0(P<0.05).In the control group,the changes of MAP,RR and HR at T1-T6 were greater than those at T0(P<0.05).The scores of CHIPPS and PAED in the observation group were lower than those in the control group at 10,20 and 30 min after recovery(P<0.05),and the CHIPPS and PAED scores of the two groups decreased gradually at 10,20 and 30 min after recovery(P<0.05).There was no significant difference in the total incidence of perioperative adverse reactions between the two groups(P>0.05).Conclusion The application of Remimazolam combined with Nalbuphine in the extraction of supernumerary teeth in children has a rapid onset of anesthesia,which can effectively reduce hemodynamic fluctuations,relieve pain during recovery period and reduce agitation during recovery period,and is safe and reliable.