探讨瑞马唑仑在舒适化口腔治疗中的镇静效果、安全性及临床应用价值。

选取2023年5月至2024年4月于河北中石油中心医院口腔门诊接受治疗的90例患者，采用随机数字表法分为A组、B组和C组，每组各30例。A组给予局部浸润麻醉联合静脉注射0.9%氯化钠注射液，B组给予局部浸润麻醉联合瑞马唑仑静脉镇静，C组给予局部浸润麻醉联合丙泊酚静脉镇静。比较3组患者手术时间、不同时间点[静脉给药后（T0）、局部浸润麻醉时（T1）、治疗时（T2）、治疗结束时（T3）、治疗结束后2 h（T4）]的生理指标[平均动脉压（mean arterial pressure，MAP）、心率（heart rate，HR）、血氧饱和度（blood oxygen saturation，SpO₂）、呼吸频率（respiratory rate，RR）、脑电双频指数（bispectral index，BIS）]、Ramsay评分、牙科焦虑量表（dental anxiety scale，DAS）评分、疼痛数字评分量表（numerical rating scale，NRS）评分、简易精神状态评估量表（mini-mental state examination，MMSE）评分、Kolcaba一般舒适状况量表（general comfort questionnaire，GCQ）评分和不良反应发生率。

MAP、HR、RR及BIS在组别主效应、时间主效应及组别与时间交互效应方面差异均有统计学意义（P<0.05），而SpO²差异无统计学意义（P>0.05）；其中T1~T3时，B组和C组MAP、HR、RR及BIS均低于A组（P<0.05），且C组T2、T3时MAP低于B组（P<0.05）。T1~T3时，B组和C组Ramsay评分均高于A组（P<0.01）；T1~T4时，B组和C组DAS评分均低于A组（P<0.01），且C组T3、T4时高于B组（P<0.01）；T1时，B组和C组NRS评分均低于A组（P<0.01）。3组治疗前后MMSE评分比较，差异无统计学意义（P>0.05）；治疗后2 h，B组和C组GCQ评分均高于A组（P<0.01）。3组不良反应总发生率比较，差异有统计学意义（P<0.05），但进一步两两比较，经Bonferroni校正后，差异均无统计学意义（P>0.05）。

瑞马唑仑在舒适化口腔治疗中的镇静效果与丙泊酚相当，有助于减轻患者焦虑和疼痛，提高治疗舒适度，且血流动力学更平稳，不良反应发生率未见明显增加，具有较好的临床应用价值。

To investigate the sedative efficacy, safety, and clinical application value of remimazolam in comfortable dental treatment.

A total of 90 patients who received treatment at the dental outpatient department of Hebei PetroChina Central Hospital from May 2023 to April 2024 were enrolled, and they were randomly divided into Group A, Group B, and Group C using the random number table method, with 30 patients in each group. Group A received local infiltration anesthesia combined with intravenous 0.9% sodium chloride solution, Group B received local infiltration anesthesia combined with remimazolam intravenous sedation, while Group C received local infiltration anesthesia combined with propofol intravenous sedation. The operative time, physiological parameters [mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO₂), respiratory rate (RR), bispectral index (BIS)] at different time points [after intravenous administration (T0), during local infiltration anesthesia (T1), during treatment (T2), at the end of treatment (T3), and 2 hours after the end of treatment (T4)], Ramsay sedation scores, dental anxiety scale (DAS) scores, numerical rating scale (NRS) scores, mini-mental state examination (MMSE) scores, Kolcaba general comfort questionnaire (GCQ) scores, and the incidence of adverse reactions were compared among the three groups.

MAP, HR, RR, and BIS showed statistically significant differences in the group main effects, time main effects, and group-by-time interactions (P<0.05), while SpO₂ showed no statistically significant difference (P>0.05). From T1 to T3, the MAP, HR, RR, and BIS in Groups B and C were lower than those in Group A (P<0.05), and the MAP in Group C was lower than that in Group B at T2 and T3 (P<0.05). From T1 to T3, the Ramsay sedation scores in Groups B and C were higher than those in Group A (P<0.01). From T1 to T4, the DAS scores in Groups B and C were lower than those in Group A (P<0.01), and the DAS scores in Group C at T3 and T4 were higher than those in Group B (P<0.01). At T1, the NRS scores in Groups B and C were lower than those in Group A (P<0.01). There was no significant difference in MMSE scores among the three groups before treatment or 2 hours after treatment (P>0.05). At 2 hours after treatment, the GCQ scores in Groups B and C were higher than those in Group A (P<0.01). There was a statistically significant difference in the total incidence of adverse reactions among the three groups (P<0.05) , but no significant pairwise difference was found after Bonferroni correction (P>0.05).

The sedative efficacy of remimazolam in comfortable dental treatment is comparable to that of propofol; it helps alleviate patient anxiety and pain and improve treatment comfort, with more stable hemodynamics and no significant increase in adverse reactions, demonstrating favorable clinical application value.