Journal of Developmental Medicine(Electronic Version)  2024, Vol. 12 Issue (5): 328-336 DOI: 10.3969/j.issn.2095-5340.2024.05.002 |
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| Risk-benefit evaluation of different doses of Remimazolam combined with Alfentanil in painless induced abortion based on the multi-criteria decision |
| Lin Weixin, Sun Hu, Lyu Song, et al
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Department of Anesthesiology, the Second Affiliated Hospital of Hainan Medical College, Hainan, Haikou 570100, China)
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Abstract 【Abstract】 Objective To evaluate the risk-benefit of different doses of Remimazolam combined with
Alfentanil in painless induced abortion based on the multi-criteria decision model. Method A total of
136 pregnant women who underwent induced abortion surgery at the Second Affiliated Hospital of Hainan
Medical University from June 2020 to February 2022 were prospectively selected as the study subjects.
According to the random number table, the pregnant women were divided into group A, group B, group C
and group D, with 34 cases in each group. The pregnant women in group A were anesthetized with Propofolcombined with Alfentanil, and the pregnant women in group B, group C and group D were anesthetized with different doses of Remimazolam (0.1 mg/kg, 0.15 mg/kg, 0.2 mg/kg) combined with Alfentanil. A multicriteriadecision model for anesthesia effect of painless induced abortion was established. Statistical methods performed by independent sample t-test, ANOVA and χ2 test. Result The onset time of anesthesia in group D was shorter than that in group A and group B [(1.6±0.4) min vs (2.3±0.6) min vs (2.0±0.4) min, t=2.634, 2.548, all P<0.05]. The visual analogue scale (VAS) score of postoperative pain in group D was lower than that in group A, group B and group C [(3.8±0.3) points vs (4.5±0.8) points vs (4.7±0.8) pointsvs (4.5±0.5) points, t=4.085, 3.293, 3.169, all P<0.05]. The Ramsay scores of group A and group D were(5.4±0.5) points and (5.4±0.5) points, respectively, which were higher than those in group B [(4.6±0.4)points] and group C [(4.8±0.4) points](group A vs group B and group C, t=3.516, 3.748; group D vs group Band group C, t=3.976, 4.526, all P<0.05). After anesthesia (T1), the mean arterial pressure (MAP) of group Awas (59.4±4.4) mm Hg (1mm Hg=0.133 kPa), heart rate (HR) was (73.3±6.3) times/min, oxygen saturation(SpO2) was (87.2±4.4)%, respiratory rate (RR) was (11.4±2.3) times/min, and bispectral index (BIS) was56.3±5.8, the fluctuations range was significant compared with the other three groups (group A vs groupB, t=8.237, 2.835, 2.823, 2.857, 3.257; group A vs group C, t=8.574, 2.674, 2.457, 2.632, 3.485; group A vsgroup D, t=8.634, 2.823, 2.162, 2.934, 5.238; all P<0.05). By applying the Meta-analysis method to merge theresults of four groups, it was found that compared with group A, group B and group C, the anesthesia onsettime, Ramsay score, postoperative VAS score, MAP, HR, SpO2, RR, and BIS of pregnant women in group Dwere significantly improved. The total effective rate was significantly increased, and the incidence of adversereactions was significantly reduced, indicating that group D had a better anesthesia effect. By calculatingthe benefit value, risk value, and risk- benefit total value of the four groups, the results show that benefitswere high, and risks were low in group D. When both benefits and risks were important, the risk-benefit totalvalue of anesthesia method in group D was the highest. Regardless of how the relative weight of risk-benefitchanges, the evaluation results of the model remain unchanged, indicating the model has good stability. Conclusion In the painless induced abortion operation, 0.2 mg/kg Remimazolam combined with Alfentanil has a good anesthetic effect, which can effectively maintain stable vital signs and reduce the incidence of adverse reactions.
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Received: 16 March 2023
Published: 08 October 2024
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