不同剂量甲苯磺酸瑞马唑仑对老年结直肠手术患者的麻醉诱导观察  

Observation on Anesthesia Induction of Remimazolam Tosilate at Different Doses in Elderly Patients Undergoing Colorectal Surgery

作　　者：张庆洪[1] 刘洋[1] 马达 张凌宇[1] ZHANG Qinghong;LIU Yang;MA Da;ZHANG Lingyu(不详;The First Affiliated Hospital of Xiamen University,Xiamen 365100,China)

机构地区：[1]厦门大学附属第一医院,福建厦门365100

出　　处：《中外医学研究》2022年第22期33-37,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨不同剂量甲苯磺酸瑞马唑仑对老年结直肠手术患者的麻醉诱导效果。方法:以2021年1-10月在厦门大学附属第一医院治疗的89例老年结直肠癌患者为研究对象,根据随机数表的方法分为低剂量组(30例)、中剂量组(29例)和高剂量组(30例)。低剂量组麻醉诱导采用甲苯磺酸瑞马唑仑0.2 mg/kg+舒芬太尼0.4 g/kg+顺阿曲库铵0.2 mg/kg;中剂量组麻醉诱导采用甲苯磺酸瑞马唑仑0.3 mg/kg+舒芬太尼0.4 g/kg+顺阿曲库铵0.2 mg/kg;高剂量组麻醉诱导采用甲苯磺酸瑞马唑仑0.4 mg/kg+舒芬太尼0.4 g/kg+顺阿曲库铵0.2 mg/kg。三组麻醉维持为甲苯磺酸瑞马唑仑0.4~1.2 mg/(kg·h)+瑞芬太尼0.1~0.2 g/(kg·min)。记录比较三组患者麻醉诱导前(T_(0))、BIS≤60时(T_(1))和气管插管后(T_(2))的脉搏氧饱和度(SpO_(2))、心率(HR)、平均动脉压(MAP)、心指数(CI)和每搏量指数(SVI);记录三组患者可能出现的需补救情况及不良反应发生情况。结果:低剂量组与中剂量组在各时间点的SpO_(2)、HR、MAP、CI、SVI比较,差异无统计学意义(P>0.05),低剂量组与高剂量组在T_(1)和T_(2)时的SpO_(2)、HR、MAP、CI、SVI比较,差异有统计学意义(P<0.05),中剂量组与高剂量组在T_(1)和T_(2)时的SpO_(2)、HR、MAP、CI、SVI比较,差异有统计学意义(P<0.05);但低剂量组有5例追加1次甲苯磺酸瑞马唑仑;高剂量组有2例低血压,1例低氧血症,1例心动过缓,三组间不良反应比较,差异有统计学意义(P<0.05)。结论:甲苯磺酸瑞马唑仑用于老年结直肠手术时麻醉诱导效果好,且剂量为0.3 mg/kg时安全性更高。Objective:To investigate the effect of different doses of Remimazolam Tosilate on anesthesia induction in elderly patients undergoing colorectal surgery.Method:A total of 89 elderly patients with colorectal cancer treated in the First Affiliated Hospital of Xiamen University from January to October 2021 were selected as the research objects,and were divided into low-dose group(30 cases),medium-dose group(29 cases)and high-dose group(30 cases)according to the random number table method.In the low-dose group,0.2 mg/kg Remimazolam Tosilate+0.4 g/kg Sufentanil+0.2 mg/kg Cis-atracurium were used for anesthesia induction.In medium-dose group,0.3 mg/kg Remimazolam Tosilate+0.4 g/kg Sufentanil+0.2 mg/kg Cis-atracurium were used for anesthesia induction.In high-dose group,0.4 mg/kg Remimazolam Tosilate+0.4g/kg Sufentanil+0.2 mg/kg Cis-atracurium were used for anesthesia induction.The maintenance of anesthesia in all three groups were Remimazolam Tosilate 0.4-1.2 mg/(kg·h)+0.1-0.2μg/(kg·min)Remifentanil.Pulse oxygen saturation(SpO_(2)),heart rate(HR)and mean arterial pressure(MAP),cardiac index(CI)and stroke volume index(SVI)were recorded and compared before anesthesia induction(T_(0)),BIS≤60(T_(1))and after endotracheal intubation(T_(2))in the three groups.The possible remedial situations and the occurrence of adverse reactions were recorded in the three groups.Result:There were no statistically significant differences in SpO_(2),HR,MAP,CI and SVI between the low-dose group and the medium-dose group at each time point(P>0.05),while there were statistically significant differences in SpO_(2),HR,MAP,CI and SVI between the low-dose group and the high-dose group at T_(1) and T_(2)(P<0.05).The comparison of SpO_(2),HR,MAP,CI and SVI between the medium-dose group and the high-dose group at T_(1)and T_(2) were statistically significant differences(P<0.05).In the low-dose group,5 patients were supplemented with Remimazolam Tosilate once,there were 2 cases of hypotension,1 case of hypoxemia and 1 case of bradycardia in the hi

关 键 词：甲苯磺酸瑞马唑仑 老年 结直肠手术 麻醉诱导 

分 类 号：R614[医药卫生—麻醉学] R735.34[医药卫生—外科学]