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瑞马唑仑在临床应用中的研究进展
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Abstract:
镇静类药物在临床麻醉与危重症监护中发挥着不可替代的作用，主要分为苯二氮卓类与非苯二氮卓类二种。苯二氮卓类药物是临床麻醉中广泛应用的中枢神经系统抑制剂，如咪达唑仑、地西泮和瑞马唑仑(remimazolam)等。苯二氮卓类药物与其他麻醉药物合用能舒缓患者术前紧张焦虑的情绪，加强其他麻醉药物的作用，减少其他麻醉药物的剂量，增加麻醉过程中的安全性和稳定性。瑞马唑仑是一种水溶性苯二氮卓类镇静药物，近期被众多国家批准应用于临床，现阶段已用于全身麻醉、程序性麻醉、局部麻醉和重症监护等领域。对比其他类别常用的镇静药物，瑞马唑仑具有起效快、代谢快、恢复快、无蓄积和不良反应较轻微等优点。在本文中，作者拟从瑞马唑仑的化学结构、作用机制、应用剂量、临床应用与不良反应等方面进行综述，就目前为止瑞马唑仑在临床麻醉镇静中的适用性与安全性做出阐述。
Sedative drugs play an irreplaceable role in clinical anesthesia and critical care, which are mainly divided into benzodiazepines and non-benzodiazepines. Benzodiazepines are widely used as central nervous system inhibitors in clinical anesthesia, such as midazolam, diazepam and remimazolam. The combination of benzodiazepines and other narcotic drugs can relieve the nervous anxiety of patients before surgery, strengthen the effect of other narcotic drugs, reduce the dose of other narcotic drugs, and increase the safety and stability of the anesthesia process. Remazolam, a water-soluble benzodiazepine sedative, has recently been approved for clinical use in many countries, and has been used in general anesthesia, procedural anesthesia, local anesthesia and intensive care. Compared with other commonly used sedative drugs, remazolam has the advantages of rapid onset, rapid metabolism, rapid recovery, no accumulation and mild adverse reactions. In this paper, the author intends to review the chemical structure, mechanism of action, dose, clinical application and adverse reactions of remazolam, and explain the applicability and safety of remazolam in clinical anesthesia and sedation so far.
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