瑞马唑仑对断指再植患者的影响
马亭亭 李建玲（通讯作者）

承德医学院附属医院，河北承德，067000；

摘要：断指再植手术对手部功能恢复至关重要，但手术过程复杂且漫长，术中常需辅助镇静药物。瑞马唑仑作为一种新型超短效苯二䓬类镇静药，其快速起效、短作用时间及可预测性，在临床麻醉中受到广泛关注。通过介绍瑞马唑仑的药理特性，包括其药物分类、化学结构、作用机制及药代动力学特点,重点分析了瑞马唑仑对血流动力学、断指再植术后恢复等影响。通过文献回顾，可以为临床提供合理的瑞马唑仑用药剂量，以优化断指再植患者的术后管理。

关键词：瑞马唑仑；断指再植；术后管理

参考文献

[1]蔡嘉琳,颜景佳.瑞马唑仑复合纳布啡在老年无痛胃肠镜中的效果[J].中外医学研究,2024,22(21):49-52

[2]Keam SJ.Remimazolam:first approval[J]．Drugs，2020，80(6):625-633

[3]卢虎强,董晨明,蒋建国,等.瑞马唑仑在ICU中的应用进展[J].中国医药导刊,2024,26(5):437-442.

[4]Birgenheier NM,Stuart AR,Egan TD.Soft drugs in anesthesia:remifentanil as prototype to modern anesthetic drug development.Curr Opin Anaesthesiol.2020 Aug;33(4):499-505.

[5]Chen W,Chen S,Huang Y.Induction and maintenance of procedural sedation in adults: focus on remimazolam injection.Expert Rev Clin Pharmacol.2021 Apr;14(4):411-426.

[6]Kleiman RB,Darpo B,Thorn M,Stoehr T,Schippers F.Potential strategy for assessing QT/QTc interval fo drugs that produce rapid changes in heart rate:Electrocardiographic assessment of the effects of intravenous remimazolam on cardiac repolarization.Br J Clin Pharmacol.2020 Aug;86(8):1600-1609.

[7]Schüttler J,Eisenried A,Lerch M,Fechner J,Jeleazcov C,Ihmsen H.Pharmacokinetics and Pharmacodynamics of Remimazolam(CNS 7056) after Continuous Infusion in Healthy Male Volunteers:Part I.Pharmacokinetics and Clinical Pharmacodynamics.Anesthesiology.2020 Apr;132(4):636-651.

[8]Pesic M，Schippers F，Saunders Ｒ，et al．Pharmacokinetics and pharmacodynamics of intranasal remimazolam-a randomized controlled clinical trial[J]．Eur J Clin Pharmacol，2020，76(11):1505-1516．

[9]旷光华,徐伟,夏瑞.瑞马唑仑的应用现状及其研究进展[J].实用医学杂志,2022,38(13):1695-1700. 

[10]Lohmer LL,Schippers F,Petersen KU,Stoehr T,Schmith VD.Time-to-Event Modeling for Remimazolam for the Indication of Induction and Maintenance of General Anesthesia.J Clin Pharmacol.2020 Apr;60(4):505-514.

[11]Sheng XY，Liang Y，Yang XY，et al．Safety，pharmacokinetic and pharmacodynamic properties of single ascending dose and contin uous infusion of remimazolam besylate in healthy Chinese volun teers[J]．Eur J Clin Pharmacol，2020，76(3):383-391．

[12]林清惠,温财春,阙邱敏,等.围术期心理护理对手外伤患者术后疼痛及睡眠质量的影响研究[J].世界睡眠医学杂志,2019,6(10):1405-1406.

[13]郭绍勇,黄素萍.断指再植治疗手指末节完全离断患者的成活率及再植成活的影响因素分析[J].黑龙江医学,2022,46(5):535-537,540.

[14]冯厚海,卫阔,肖滋润.小剂量抗焦虑药物预防断指再植术后血管危象效果分析[J].青岛医药卫生,2021,53(2):139-141.

[15]林国锐,刘桦,谭间梅,等. 右美托咪定应用于急诊手外伤高血压患者臂丛神经阻滞麻醉中的安全性和有效性研究[J].中国现代药物应用,2019,13(15):98-100.

[16]齐文勇,党友,王普育,吴召森.瑞马唑仑联合罗哌卡因在断指再植术中的应用效果[J].河南医学研究,2024,33(10):1777-1780.

[17]宋尧,覃禹翱,夏雪,李林,邹学军.瑞马唑仑与右美托咪定在超声引导臂丛神经阻滞断指再植术中的麻醉效果比较[J].实用医学杂志,2023,39(24):3243-3248.

[18]杜兴雨,战春飞,王琼,等.甲苯磺酸瑞马唑仑与盐酸右美托咪定在断指再植术中的应用效果对比[J].现代医学与健康研究电子杂志,2023,7(17):30-32.

[19]Alberto F.Cintrón-Colón;Gabriel Almeida-Alves;Juliana M.VanGyseghem;John M.Spitsbergen;.GDNF to the rescue: GDNF delivery effects on motor neurons and nerves, and muscle re-innervation after peripheral nerve injuries[J].Neural Regeneration Research,2022(04):54-59.

[20]Julia Spiegelberg;Hannes Neeff;Philipp Holzner;Mira Runkel;Stefan Fichtner-Feigl;Torben Glatz;.Comparison of hyperthermic intraperitoneal chemotherapy regimens for treatment of peritoneal-metastasized colorectal cancer[J].World Journal of Gastrointestinal Oncology,2020(08):117-131.

[21]Sixue Liu;Zuyu Yang;Guanghao Li;Chunyan Li;Yanting Luo;Qiang Gong;Xin Wu;Tao Li;Zhiqian Zhang;Baocai Xing;Xiaolan Xu;Xuemei Lu;.Multi-omics Analysis of Primary Cell Culture Models Reveals Genetic and Epigenetic Basis of Intratumoral Phenotypic Diversity[J].Genomics,Proteomics & Bioinformatics,2019(06):32-45.

[22]杨凤艳,张月,陈恩贤,缪雪蓉,魏凯.瑞马唑仑临床应用研究进展[J].药学实践与服务,2024,42(09):365-374.

[23]刘俊,张永强,李晓芳,等.不同剂量瑞马唑仑对腹横肌平面阻滞下行腹膜透析置管术肾衰竭患者的镇静效果比较[J].新乡医学院学报,2023,40(10):926-93

[24]彭蕊,王倩,杨天爽,等.不同剂量瑞马唑仑复合舒芬太尼在无痛胃镜检查术中的比较[J].临床麻醉学杂志,2023,39(4):389-392.

[25]Stöhr T，Colin PJ，Ossig J，et al．Pharmacokinetic properties of remimazolam in subjects with hepatic or renal impairment[J]．Br J Anaesth，2021，127(3):415-423．

[26]Pesic M，Schippers F，Saunders R，et al．Pharmacokinetics and pharmacodynamics of intranasal remimazolam-a randomized controlled clinicaltrial[J]．Eur J Clin Pharmacol，2020，76(11):1505-1516．

[27]袁君晓寒,白晓峰,张霞.新型镇静药瑞马唑仑药代动力学及药效学研究进展[J].实用药物与临床,2024,27(3):216-221.