Evaluation of the anaesthetic effect of the combination of remimazolam—alfentanil—mivacurium in pe-diatric fiberoptic bronchoscopy

HU Deming; GAN Luping; WANG Shengqiang; YIN Lin; HUANG Ailian; LIAO Mei

Abstract：Objective:To study the characteristics and safety of anaesthetic effect of the combination of remimazo-lam-alfentanil-mivacurium in pediatric fiberoptic bronchoscopy.Methods:Eighty children who would undergo fiber-optic bronchoscopy in yichun people's hospital from April 2024 to August 2024 were selected,and the patients were di-vided into Group R(remimazolam-alfentanil-mivacurium),and Group B(propofol-fentanyl-benzenesulfonium at-racurium)(n=40)by using the random number table method.Mean arterial pressure(MAP),heart rate(HR),blood pressure saturation(SpO2),and partial pressure of end-expiratory carbon dioxide(PETCO2)were recorded at each time point before induction of anaesthesia(t0),at the time of placing the laryngeal mask(t1),at the time of fibrinosco-py to the tracheal bulge(t2),at the beginning of the surgery for 10 min(t3),at the end of the surgery(t4),and when the children were awake(t5)in two groups were compared.The incidence of adverse reactions such as the presence of choking during induction of anaesthesia,postoperative awakening time,degree of sedation(Ramsay score),degree of re-covery of muscle tone,and the incidence of adverse reactions such as respiratory depression,nausea and vomiting,and agitation in two groups were compared.Results:It was found that intraoperative MAP and HR levels of children in group R were better than those in group B at t1,t2,t3 and t4,and SpO2 and PETCO2 were better than those in group B at t5,with statistically significant differences(P＜0.05).The incidence of adverse reactions such as choking during induc-tion,postoperative awakening time,Ramsay score,degree of recovery of muscle tone,degree of nausea and vomiting agi-tation,and respiratory depression in the children in group R were smaller than those in group B,and the differences were all statistically significant(P＜0.05).Conclusion:The anaesthesia effect of the combination of remimazolam-al-fentanil-mivacurium in paediatric fibreoptic bronchoscopy is feasible and superior.Compared with propofol-fentany-benzenesulfonium,there is a low incidence of choking and coughing during the induction of anaesthesia,a smooth intra-operative haemodynamics,appropriate level of sedation and good muscle tone,a rapid awakening in the postoperative period,a low incidence of nausea,vomiting,restlessness,respiratory depression and other adverse reactions,which can effectively improve the prognosis of the children and enhance the safety and comfort of the children during the perioper-ative anaesthesia.