A comparative study on the sedative effect and pulmonary function impact of remazolam and midazolam in patients with invasive mechanical ventilation

Xia Jiading; Li Longxin

doi:10.3760/j.issn.1673-4777.2024.05.011

Abstract：Objective To explore the sedative effect of remazolam and midazolam on pulmonary function in patients with invasive mechanical ventilation.Methods A total of 90 patients who underwent invasive mechanical ventilation in the Affiliated Hospital of Chengde Medical College from February to September 2023 were selected.The patients were divided into control group(44 cases)and observation group(46 cases)by random number table method.The control group was given midazolam for sedation on the basis of conventional remifentanil.The observation group was given remazolam tosilate for sedation on the basis of conventional remifentanil.The degree of sedation,pulmonary function,blood gas analysis indexes,oxidative stress and inflammatory response indexes,and adverse events were compared between the two groups.Results The Richmond restlessness sedation scores in the observation group were lower than those in the control group at 30 min,4 h,12 h and 24 h after administration[(-0.93±0.11)vs(-0.88±0.12),(-1.08±0.08)vs(-0.99±0.12),(-1.11±0.09)vs(-1.06± 0.11),and(-1.18±0.07)vs(-1.10±0.09)](all P＜0.05).After sedation,the platform pressure,heart rate,mean arterial pressure,levels of malondialdehyde,and interleukin-6 in the observation group were lower than those in the control group,and the pulmonary static compliance,pulse oxygen saturation,and superoxide dismutase levels were higher than those in the control group(all P＜0.05).The total incidence of adverse events in the observation group was lower than that in the control group,but the difference was not statistically significant(x2=0.973,P=0.324).Conclusion The application of remazolam or midazolam in patients with invasive mechanical ventilation can improve the sedative effect,which is conducive to the promotion and smooth progress of invasive mechanical ventilation,improve the pulmonary function of patients,reduce oxidative stress and inflammatory response,and the anesthetic and sedative effect of remazolam is better than midazolam.