|
| 瑞马唑仑用于经皮穿刺椎体后凸成形术患者围术期镇静的效果 |
| Perioperative sedative effect of remimazolam in patients undergoing percutaneous kyphoplasty |
| |
| DOI：10.12089/jca.2022.09.004 |
| 中文关键词: 瑞马唑仑 右美托咪定 经皮穿刺椎体后凸成形术 镇静 |
| 英文关键词: Remimazolam Dexmedetomidine Percutaneous kyphoplasty Sedation |
| 基金项目:湖北省自然科学基金面上项目（2020CFB705） |
|
| 摘要点击次数: 1486 |
| 全文下载次数: 453 |
| 中文摘要: |
目的 探讨瑞马唑仑应用于经皮穿刺椎体后凸成形术（PKP）患者围术期镇静的效果。
方法 选择行PKP患者80例，男39例，女41例，年龄60～80岁，BMI 18～24 kg/m2，ASA Ⅱ或Ⅲ级。采用随机数字表法将患者分为两组：瑞马唑仑组（RM组）和右美托咪定组（DM组），每组40例。两组依次缓慢静脉注射氟比洛芬酯1 mg/kg、舒芬太尼0.2 μg/kg后，RM组静脉输注瑞马唑仑0.2 mg/kg，DM组静脉输注右美托咪定0.3 μg/kg，输注时间均为10 min，待两组Ramsay评分为3分时，调整药物的输注速度持续镇静（RM组：0.3～0.5 mg·kg-1·h-1；DM组：0.20～0.75 μg·kg-1·h-1），术中镇静深度保持Ramsay评分为3～5分，BIS 60～80。记录镇静用药前（T0）、局麻开始时（T1）、骨水泥注入时（T2）、苏醒时（T3）及苏醒后30 min（T4）的Ramsay评分和BIS。记录镇静起效时间、苏醒时间和术中知晓的发生情况。
结果 与T0时比较，T1、T2时RM组Ramsay评分及BIS均明显降低（P<0.05），T1、T4时DM组Ramsay评分及BIS均明显降低（P<0.05）。与DM组比较，T3、T4时RM组Ramsay评分明显降低、BIS明显升高（P<0.05），RM组镇静起效时间和苏醒时间均明显缩短（P<0.05），RM组术中知晓发生率明显降低（P<0.05）。
结论 瑞马唑仑或右美托咪定用于PKP患者，术中均能获得良好的镇静效果且对患者呼吸及循环功能影响较小。与使用右美托咪定的患者比较，使用瑞马唑仑的患者镇静起效时间和苏醒时间明显缩短、术中知晓发生率明显降低，术后苏醒质量明显提升。 |
| 英文摘要: |
Objective To investigate the perioperative sedative effect of remimazolam in percutaneous kyphoplasty (PKP) patients during surgery and after recovery.
Methods Eighty patients, including 39 males and 41 females, aged 60-80 years, BMI 18-24 kg/m2, ASA physical status Ⅱ or Ⅲ, scheduled for elective PKP, were randomly divided into two groups: remimazolam group (group RM) and dexmedetomidine group (group DM), 40 patents in each group. The patients in the two groups were intravenously injected with flurbiprofen axetil 1 mg/kg and sufentanil 0.2 μg/kg, then the patients in group RM were infused with remimazolam 0.2 mg/kg, and the patients in group DM were infused with dexmedetomidine 0.3 μg/kg. The expected infusion time for both groups was 10 minutes. When the Ramsay score was 3 points, the infusion speed of the drug was adjusted for continue sedation (group RM: 0.3-0.5 mg·kg-1·h-1; group DM: 0.20-0.75 μg·kg-1·h-1), and the intraoperative sedation depth was maintained with Ramsay score of 3-5 points and BIS value of 60-80. The changes of Ramsay score and bispectral index (BIS) were recorded before sedation (T0), at the local anesthesia (T1), at the bone cement injection (T2), at the time of awakening (T3), and at the half an hour after awakening (T4). Other index were recorded including the sedation onset time, wake-up time and cases of intraoperative awareness.
Results Compared with T0, the Ramsay score and BIS value in group RM were significantly decreased at T1-T2(P < 0.05), and the Ramsay sedation score and BIS value in group DM were significantly decreased at T1-T4(P < 0.05). Compared with group DM, the Ramsay score was significantly decreased and the BIS value was significantly increased in group RM at T3-T4 (P < 0.05). The sedation onset time and wake-up time in group RM were significantly shortened (P < 0.05), and the incidence of intraoperative awareness in group RM was significantly reduced (P < 0.05).
Conclusion In the sedation scheme of PKP surgery, both remimazolam and dexmedetomidine can achieve good intraoperative sedation effect and has little influence on the patient's respiratory and circulatory function. Compared with the patients using dexmedetomidine, the sedation onset time and recovery time of the patients using remazolam were significantly shorter, the incidence of intraoperative awareness was significantly lower, and the quality of postoperative recovery was significantly improved. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
