艾司氯胺酮复合瑞马唑仑在老年患者全身麻醉诱导中的应用  

Application of esketamine and remimazolam in induction of general anesthesia in elderly patients

作　　者：袁柳青 李晓玲[1] YUAN Liu-qing;LI Xiao-ling(Department of Anesthesiology,the First Affiliated Hospital of Gannan Medical University,Ganzhou JIANGXI 341000,China)

机构地区：[1]赣南医学院第一附属医院麻醉科,江西赣州341000

出　　处：《中国新药与临床杂志》2023年第1期28-31,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的探讨艾司氯胺酮复合瑞马唑仑在老年患者全身麻醉诱导中应用的效果。方法选择择期行妇科腹腔镜手术患者60例,年龄65~75岁,随机分为观察组和对照组,每组30例。对照组采用咪达唑仑0.05 mg·kg^(-1)复合丙泊酚1 mg·kg^(-1)麻醉诱导,观察组采用瑞马唑仑0.1 mg·kg^(-1)复合艾司氯胺酮0.5 mg·kg^(-1)诱导。2组麻醉维持方案相同,脑电双频指数(BIS)值维持在40~60。记录患者麻醉前、插管前和插管3 min后的血压和心率,以及术中和术后药物不良反应的发生情况。结果与麻醉前比较,插管前和插管3 min后2组血压和心率均显著下降(P<0.05),对照组下降幅度显著大于观察组(P<0.05)。插管前观察组的血压高于对照组(P<0.05),心率组间比较无显著差异(P>0.05)。麻醉诱导期对照组发生低血压16例(53%),观察组发生5例(17%),观察组低血压发生率显著低于对照组(P<0.05),其他术中和术后不良反应发生率组间比较无显著差异(P>0.05)。结论应用艾司氯胺酮复合瑞马唑仑麻醉诱导,老年患者血流动力学更平稳,且不增加不良反应的发生率。AIM To investigate the effects of esketamine and remimazolam for general anesthesia induction in elderly patients.METHODS A total of 60 patients undergoing gynecologic laparoscopic surgery,age from 65 to 75 years,were randomly divided into the observation group and the control group(30 cases in each group).Anesthesia was induced with either intravenous midazolam 0.05 mg·kg^(-1)plus propofol 1 mg·kg^(-1)in the control group or remimazolam 0.1 mg·kg^(-1)plus esketamine 0.5 mg·kg^(-1)in the observation group.Anesthesia was maintained with the same method in both groups to keep the bispectrail index(BIS)value between 40 to 60.Blood pressure and heart rate were monitored before anesthesia induction,immediately before intubation,and 3 min after intubation.The drug-related adverse reactions were recorded during intra-operation and post-operation.RESULTS The blood pression and heart rate immediately before intubation and 3 min after intubation were decreased in both groups compared with those before anesthesia(P<0.05).And the decrease in the control group was significantly greater than that in the observation group(P<0.05).The blood pressure immediately before intubation was higher in the observation group than that in the control group(P<0.05),while there was no significant differences in heart rate between the two groups(P>0.05).There were 16 cases of hypotension(53%)occurred during the anesthesia induction in the control group and 5 cases of hypotension(17%)in the observation group.The incidence of hypotension was lower during anesthesia induction in the observation group compared with the control group(P<0.05),but there were no differences in terms of other drug-related adverse reactions between the two groups(P>0.05).CONCLUSION The hemodynamics are more stable in elderly patients using remimazolam and esketamine for anesthesia induction without increasing the incidence of the adverse reactions.

关 键 词：瑞马唑仑 艾司氯胺酮 丙泊酚 麻醉 全身 

分 类 号：R971[医药卫生—药品]