Analysis of the effect of remimazolam on adjunctive sedation during spinal puncture
Zhang Ye
Ming Guangfu
Zhang Min
Yu Xiaodong
Abstract：Objective To investigate the safety and efficacy of remimazolam as adjunctive sedation during spinal puncture in patients undergoing knee replacement surgery.Methods Sixty patients who underwent knee joint replacement surgery under spinal anesthesia at Hainan General Hospital from March 2022 to May 2023 were selected.The American Association of Anesthesiologists graded them as Grade Ⅰ-Ⅲ and divided into three groups using a random number table method:control group(group C),remimazolam 0.04 mg/kg group(group R1)and remimazolam 0.06 mg/kg group(group R2),with 20 cases in each group.After positioning the left flexion position,all patients were slowly injected with normal saline and remimazolam 0.04 mg/kg and 0.06 mg/kg,respectively,and Lumbar puncture was performed under local anesthesia in the L2-3 space 1 minute later.Heart rate(HR),mean arterial pressure(MAP),pulse oxygen saturation(SpO2),modified observer's assessment of alertness/sedation(MOAA/S)score and patient satisfaction were recorded before administration and 1,2,3,4,5,6,7,8,9,10,15 min after administration.Results HR and MOAA/S scores at 2,3,4,5,6,7,8,9,10 min after administration in group R2 were lower than those in group C(all P＜0.05),and MAP at 4,5,6 min after administration in group R2 were lower than those in group C(all P＜0.05).The MOAA/S scores in group R2at2,3,4,5,6,7,8 min after administration were lower than those in group R1(all P＜0.05).HR at 3,4,5,6,7,8,9,10,15 min after administration in group R2 were lower than those before administration(all P＜0.05),and MAP at 4,5,6,7,8,9,10,15 min after administration in group R2 were lower than those before administration(all P＜0.05).MOAA/S scores at 2,3,4,5,6,7,8,9,10 min after administration in group R2 were lower than those before administration(all P＜0.05).There were no significant differences in SpO2 among the three groups at each time point(all P＞0.05).The very satisfied percentage of patients in group R2 were higher than those in group R1 and group C[90.0％(18/20)vs 60.0％(12/20),30.0％(6/20)](both P＜0.05).Conclusion The use of 0.06 mg/kg remimazolam has better sedative effect during spinal puncture in patients undergoing knee replacement,with little effect on respiratory depression,stable HR and blood pressure,and high safety.
Keywords：Knee replacementRemimazolamSpinal punctureAssisted sedation
Publication Date：2024-07-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1056-1060 )