Alternative Title経カテーテル的大動脈弁置換術を受ける患者における麻酔導入時のレミマゾラムとプロポフォールの全静脈麻酔の血行動態の比較：無作為化比較試験
Note (General)type:Thesis
Purpose: This study aimed to compare the hemodynamic effects of remimazolam- and propofol-based total intravenous anesthesia in patients who underwent transcatheter aortic valve replacement. Methods: This was a single-center, single-blind, randomized controlled trial set at Nara Medical University, Kashihara, Japan. We included 36 patients aged ≥ 20 years scheduled to undergo elective transfemoral transcatheter aortic valve replacement (TAVR) under general anesthesia. The participants were randomly assigned to the remimazolam and propofol groups (n=18 each). Remimazolam- or propofol-based total intravenous anesthesia was initiated at 12 mg/kg/min or 2.5 mcg/mL via target-controlled infusion, respectively, along with remifentanil. After confirming the loss of consciousness, the administration rate was adjusted using electroencephalographic monitoring. The primary outcome was the rate of arterial hypotension, defined as a mean arterial pressure <60 mmHg, from anesthesia induction until the beginning of the surgical incision. The total doses of ephedrine and phenylephrine were also assessed. Results: During anesthesia induction, the arterial hypotension rates were 11.9% and 21.6% in the remimazolam and propofol groups, respectively (P=0.01). The total dose of ephedrine was higher in the propofol group (14.4 mg) than in the remimazolam group (1.6 mg) (P<0.001); however, the total dose of phenylephrine was not significantly different between the two groups (propofol: 0.31 mg vs. remimazolam: 0.17 mg, P=0.10). Conclusions: Remimazolam-based total intravenous anesthesia resulted in a lower hypotension rate than propofol-based total intravenous anesthesia during induction in patients undergoing TAVR. Remimazolam-based total intravenous anesthesia can be used safely during anesthetic induction in patients with severe aortic stenosis.
権利情報：© The Author(s) under exclusive licence to Japanese Society of Anesthesiologists 2024. This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s00540-024-03311-x
identifier:Journal of anesthesia. 2024 Jun, vol.38, no.3, p.330-338
identifier:0913-8668
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4389
identifier:Journal of anesthesia, 38(3): 330-338
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2025-03-07T22:45:06+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション