Comparative Study on Remimazolam Mesylate and Propofol for Radiofrequency Thermocoagulation of Trigeminal Neuralgia under Deep Sedation

doi:10.13701/j.cnki.kqyxyj.2023.11.007

Abstract

Abstract: Objective: To compare the efficacy and safety of remimazolam mesylate and propofol for radiofrequency thermocoagulation of trigeminal neuralgia under deep sedation. Methods: A total of 78 patients who underwent elective radiofrequency thermocoagulation of the trigeminal nerve under deep sedation were enrolled and randomly divided into group R and B (n=39). Patients in group B were anesthetized with propofol combined with remifentanil, while those in group R were anesthetized with remimazolam combined with remifentanil. The mean arterial pressures, heart rates, and pulse oxygen saturations of both groups were compared at five time points: 5 minutes before anesthesia (T1), the time of modified alertness/sedation score (MOAA/S) ≤3 (T2), the time of beginning of radiofrequency thermocoagulation (T3), the time of the end of radiofrequency thermocoagulation (T4), and the time of awakening (T5). Furthermore, both groups were compared for the adverse reaction (respiratory inhibition, circulatory inhibition, body movements during administration to MOAA/S≤3 and operation, and injection pain), and for the modes of assisted breathing (mask oxygenation, oxygenation by mandibular lift and face mask, and oxygenation by mandibular lift and face mask under pressure). Results: Compared with those at T1, both MAP and SpO₂ decreased at T2 and SpO₂ decreased at T3 and T4 in group B (P<0.05), while only SpO₂ reduced at T3 in group R (P<0.05). Compared with group B, the incidence of breathing inhibition, injection pain and oxygen administration with mandibular lift and face mask under pressure were reduced in group R (P<0.05), while SpO₂ was increased at T2 and T4, and the incidence of body movement during administration to MOAA/S≤3 and the incidence of oxygen administration using a mask were increased (P<0.05). Other indicators were not significantly different between two groups (P>0.05). Conclusion: Compared with propofol, remimazolam mesylate has a low incidence of respiratory and circulatory inhibition, no injection pain, and a simple mode of assisted breathing, which can be used more safely and effectively for radiofrequency thermocoagulation of trigeminal neuralgia under deep sedation.

Key words: remimazolam, propofol, trigeminal neuralgia, radiofrequency thermocoagulation

LI Jinjie, ZHANG Tiejun. Comparative Study on Remimazolam Mesylate and Propofol for Radiofrequency Thermocoagulation of Trigeminal Neuralgia under Deep Sedation[J]. Journal of Oral Science Research, 2023, 39(11): 973-977.

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