|
| 瑞马唑仑对老年患者腹腔镜术后苏醒质量的影响 |
| Effects of remimazolam on awakening quality in elderly patients undergoing laparoscopic surgery |
| |
| DOI：10.12089/jca.2023.10.004 |
| 中文关键词: 瑞马唑仑 老年 恢复质量 苏醒期谵妄 认知功能 |
| 英文关键词: Remimazolam Aged Quality of recovery Emergence delirium Cognitive function |
| 基金项目:山西省医师协会医师临床科研项目(YSXH-RF2022MZ005) |
| 作者 | 单位 | E-mail | | 姚文壮 | 030000,太原市,山西医科大学麻醉学院 | | | 刘苏漫 | 030000,太原市,山西医科大学麻醉学院 | | | 贺小玲 | 030000,太原市,山西医科大学麻醉学院 | | | 张涵云 | 030000,太原市,山西医科大学麻醉学院 | | | 吕洁萍 | 030000,太原市,山西医科大学麻醉学院 | 691597018@qq.com |
|
| 摘要点击次数: 1036 |
| 全文下载次数: 462 |
| 中文摘要: |
目的 探讨瑞马唑仑与丙泊酚用于全麻诱导和维持对老年患者腹腔镜术后苏醒质量的影响。
方法 选择择期在全麻下行腹腔镜手术的老年患者84例，男41例，女43例，年龄65～80岁，BMI 18.5~25.0 kg/m2， ASA Ⅱ或Ⅲ级。采用随机数字表法将患者分为两组：丙泊酚组和瑞马唑仑组，每组42例。麻醉诱导：丙泊酚组静脉注射丙泊酚1～2 mg/kg，瑞马唑仑组静脉注射瑞马唑仑0.15～0.20 mg/kg。麻醉维持：丙泊酚组静脉泵注丙泊酚4～8 mg·kg-1·h-1，瑞马唑仑组静脉泵注瑞马唑仑0.5～1.0 mg·kg-1·h-1，其余用药相同。记录停药后10、20、30 min的改良警觉镇静评分(MOAA/S)、Steward苏醒评分。分别于麻醉诱导前、术毕即刻、术后24 h抽取肘静脉血，检测血清S100β蛋白、IL-6、丙二醛(MDA)浓度。记录术毕睁眼时间、拔管时间、PACU停留时间。记录术中低血压、注射痛、呛咳、术后恶心呕吐（PONV）等不良反应的发生情况。
结果 与麻醉诱导前比较，两组术毕即刻、术后24 h血清S100β蛋白、IL-6浓度明显升高(P<0.05)，术后24 h血清MDA浓度明显降低(P<0.05)。与丙泊酚组比较，瑞马唑仑组术毕即刻、术后24 h血清S100β蛋白、IL-6浓度明显降低(P<0.05)，睁眼时间明显延长(P<0.05)，注射痛和术中低血压发生率明显降低(P<0.05)。两组停药后10、20、30 min MOAA/S评分、Steward评分、拔管时间、PACU停留时间差异无统计学意义。
结论 丙泊酚与瑞马唑仑对老年患者腹腔镜手术后苏醒质量的影响无明显差异。 |
| 英文摘要: |
Objective To explore the effect of remimazolam and propofol on awakening quality in elderly patients undergoing laparoscopic surgery.
Methods Eighty-four elderly patients undergoing laparoscopic surgery, 41 males and 43 females, aged 65-80 years, ASA physical status Ⅱ or Ⅲ, were divided into two groups by random number table method: propofol group and remimazolam group, 42 patients in each group. Anesthesia induction: the propofol group was received intravenous injection of 1-2 mg/kg of propofol, while the remimazolam group was received intravenous injection of 0.15-0.20 mg/kg of remimazolam. During maintenance of anesthesia, the propofol group was maintained by pumping propofol at 4-8 mg·kg-1·h-1, while the remimazolam group was maintained by pumping remimazolam at 0.5-1.0 mg·kg-1·h-1. MOAA/S score and Steward score of 10, 20, and 30 minutes after drug withdrawal were recorded. S100β protein, IL-6 and malondialdehyde (MDA) were detected before induction, immediately after surgery and 24 hours after surgery. Eye opening time, extubation time and PACU residence time were recorded after operation. The occurrence of intraoperative hypotension, injection pain, cough reaction, postoperative nausea and vomiting (PONV), and other adverse reactions were recorded.
Results Compared with before induction, serum S100β and IL-6 protein concentrations were significantly increased in both groups immediately after surgery and 24 hours after surgery (P < 0.05), serum MDA concentration decreased significantly 24 hours after operation (P < 0.05). Compared with propofol group, in remimazolam group serum S100β protein and IL-6 concentrations were significantly decreased immediately after surgery and 24 hours after surgery (P < 0.05), eye opening time was significantly prolonged (P < 0.05), the incidence of injection pain and hypotension were significantly reduced (P < 0.05). There were no significant differences in 10, 20 and 30 minutes MOAA/S scores, Steward scores, extubation time, and PACU residence time between the two groups.
Conclusion Compared with propofol, remimazolam has no significant differences in the awakening quality of elderly patients after laparoscopic surgery. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
