摘要目的:评价瑞马唑仑用于门诊刮宫术的镇静效果。方法:选取门诊刮宫术患者80例，ASA分级Ⅰ或Ⅱ级，年龄≥18岁。采用随机数字表法分为2组：瑞马唑仑组(R组， n＝41)和丙泊酚组(P组， n＝39)。麻醉诱导：静脉注射阿芬太尼10 μg/kg，R组静脉注射瑞马唑仑7 mg，P组静脉注射丙泊酚1.5 mg/kg。若改良警觉镇静评分≥3分或者患者无法耐受手术操作，R组以瑞马唑仑2.5 mg、P组以丙泊酚0.5 mg/kg进行补救镇静，阿芬太尼1 μg/kg补救镇痛。记录镇静药起效时间、睁眼时间、清醒时间和离院时间。记录镇静成功情况、术中BIS值、药物补救情况和不良反应发生情况。 结果:R组和P组患者术中BIS值分别维持在61~72和40~64。R组镇静成功率95%，P组100%，差异无统计学意义( P>0.05)。与P组比较，R组镇静药补救率和阿芬太尼补救率升高，镇静药起效时间延长，术后恶心、呕吐发生率升高，呼吸抑制和注射痛发生率降低( P<0.05)。 结论:瑞马唑仑(按说明书剂量给药)用于门诊刮宫术较为安全，但其只能维持在浅镇静状态，镇静效果劣于丙泊酚。

abstractsObjective:To evaluate the sedative efficacy of remimazolam in outpatients undergoing curettage.Methods:Eighty outpatients, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, aged ≥18 yr, undergoing curettage, were divided into 2 groups according to the random number table method: remimazolam group (group R, n=41) and propofol group (group P, n=39). Anesthesia was induced with alfentanil 10 μg/kg injected intravenously in two groups, and in addition remimazolam 7 mg was intravenously injected in group R, and propofol 1.5 mg/kg was intravenously injected in group P. If the Modified Observer′s Assessment of Alertness/Sedation score ≥3 or the patient could not tolerate the surgical procedure, remimazolam 2.5 mg was given for rescue sedation in group R and propofol 0.5 mg/kg was given for rescue sedation in group P, and alfentanil 1 μg/kg was given as rescue analgesic.The onset time of sedatives, time to eye opening, emergence time and time to discharge were recorded.The success of sedation, intraoperative BIS value, requirement for rescue medications, and occurrence of adverse reactions were recorded. Results:The intraoperative BIS values were maintained at 61-72 and 40-64 in group R and group P, respectively.The success rate of sedation was 95% in group R and 100% in group P, and there was no significant difference between the two groups ( P>0.05). Compared with group P, the rate of rescue sedative agents used and rate of rescue alfentanil given were significantly increased, the onset time of sedative agents was significantly prolonged, the incidence of postoperative nausea and vomiting was increased, and the incidence of respiratory depression and injection pain was decreased in group R ( P<0.05 ). Conclusion:Remimazolam (given according to the instructions) is safer when used for outpatient curettage, but it can only maintain a light sedation status, and the sedative efficacy is inferior to propofol.