目的 观察瑞马唑仑用于腹腔镜胆囊切除术全身麻醉对患者血流动力学和术后应激的影响。方法 选取2022年1月—2023年1月接受腹腔镜胆囊切除术治疗的68例患者作为观察对象,采用信封法将其随机分为M组与R组,每组34例。M组麻醉诱导时使用咪达唑仑+芬太尼+苯磺顺阿曲库铵,R组麻醉诱导时采用瑞马唑仑+芬太尼+苯磺顺阿曲库铵。比较M组与R组不同时间点的血流动力学指标、不良反应及术后应激水平。结果 两组诱导前的心率、平均动脉压差异无统计学意义（P>0.05）。插管前、插管后即刻、插管后1 min,R组的心率、平均动脉压均低于M组（P<0.05）。术后24 h,R组的去甲肾上腺素、皮质醇、胰岛素、C肽水平均低于M组（P<0.05）。R组的头晕头痛发生率低于M组（P<0.05）。结论 将瑞马唑仑应用于腹腔镜胆囊切除术全身麻醉可以有效维持麻醉效果,降低患者生理应激水平,且安全性较高。

Objective To explore the effect of remimazolam on hemodynamics and postoperative stress of patients with general anesthesia for laparoscopic cholecystectomy （LC）. Methods A total of 68 patients who received LC treatment from January 2021 to January 2023 were selected as observation subjects. They were randomly divided into M group （n=34） and R group （n=34） using the envelope method. During anesthesia induction in the M group, midazolam, fentanyl, and cisatracurium besilate were used; during anesthesia induction in the R group, remimazolam, fentanyl, and cisatracurium besilate were used. The hemodynamic indicators, adverse reactions, and postoperative stress levels were compared between the M group and the R group at different time points. Results There were no statistically significant differences in heart rate （HR） and mean arterial pressure （MAP） between the two groups before induction （P>0.05）. At the time points before intubation, immediately after intubation, and 1 min after intubation, the HR and MAP in the R group were significantly lower than those in the M group （P<0.05）. At 24 h after operation, the levels of norepinephrine, cortisol, insulin, and C-peptide in the R group were significantly lower than those in the M group （P<0.05）. The incidence of dizziness and headache in the R group was significantly lower than that in the M group （P<0.05）. Conclusion When patients undergo LC treatment, using remimazolam for general anesthesia can effectively maintain the anesthesia effect, reduce their physiological stress level, and have high safety.