瑞马唑仑联合瑞芬太尼对老年眼科全麻患者术中循环功能及PONV的影响  

Effect of remazolam combined with remifentanil on intraoperative circulatory function and PONV in elderly patients taking ophthalmic general anesthesia

作　　者：赵晴[1] 吴宪登 武鹏[1] Zhao Qing;Wu Xiandeng;Wu Peng(Department of Anesthesiology,Jinan Second People's Hospital,Jinan 250000,China)

机构地区：[1]济南市第二人民医院麻醉科,济南250000

出　　处：《国际医药卫生导报》2023年第6期823-828,共6页International Medicine and Health Guidance News

摘　　要：目的探讨瑞马唑仑联合瑞芬太尼对老年眼科全麻患者术中循环功能和术后恶心呕吐(PONV)的影响。方法将济南市第二人民医院2021年4月至2022年7月接收的老年全麻手术患者94例进行随机对照试验,随机分为对照组与研究组,每组各47例。对照组男27例,女20例,年龄(67.89±7.58)岁,给予丙泊酚0.6~1.2 mg/kg麻醉诱导及4~10 mg·kg^(-1)•h^(-1) 维持;研究组男25例,女22例,年龄(68.18±7.82)岁,采用瑞马唑仑0.1~0.3 mg/kg麻醉诱导,给予瑞马唑仑0.8~1.2 mg·kg^(-1)•h^(-1) ,瑞芬太尼0.1~0.2μg·kg-1·min-1维持麻醉。比较两组患者麻醉诱导前(T_(0))、麻醉诱导成功(T_(1))、喉罩置入即刻(T_(2))、手术20 min(T3)监测患者的心脏指数(CI)、心输出量(CO)、平均动脉压(MAP)及血氧饱和度(SpO2);比较两组患者术后恶心(PON)、术后呕吐(POV)、PONV发生率及严重程度;对比两组患者麻醉苏醒指标(清醒时间、拔管时间与苏醒期间躁动)。统计学方法采用χ^(2)检验、t检验、Mann-Whitney U检验。结果研究组T_(1)、T_(2)、T3的CI均高于对照组同期[(2.89±0.43)min•m^(-2)比(2.64±0.41)min•m^(-2)、(2.71±0.37)min•m^(-2)比(2.54±0.33)min•m^(-2)、(2.85±0.40)min•m^(-2)比(2.60±0.38)min•m^(-2)];研究组T_(1)、T_(2)、T3的CO均高于对照组同期[(5.26±0.47)L/min比(4.92±0.43)L/min、(4.72±0.41)L/min比(4.46±0.38)L/min、(5.10±0.45)L/min比(4.78±0.40)L/min];研究组T_(2)的MAP高于对照组同期[(75.50±6.73)mmHg比(72.14±6.25)mmHg,t=2.508,P<0.05];研究组T_(2)、T3的SpO2均高于对照组同期,差异均有统计学意义(t=2.699、2.209,均P<0.05);研究组术后48 h内PON、POV及PONV发生率均低于对照组(χ^(2)=4.065、4.821、5.317,均P<0.05);研究组术后6 h的PON及POV严重程度评分均低于对照组同期(Z=2.403、2.354,均P<0.05);研究组术后12 h的PON及POV严重程度评分均低于对照组同期(Z=2.136、2.081,均P<0.05);研究组清醒时间、拔管时间均长于对照组[(20.40�Objective To explore the effect of remazolam combined with remifentanil on intraoperative circulatory function and postoperative nausea and vomiting(PONV)in elderly patients taking ophthalmic general anesthesia.Methods Ninety-four elderly patients undergoing general anesthesia surgery in Ophthalmic Operating Room,Jinan Second People's Hospital from April 2021 to July 2022 were randomly divided into a control group and a study group, with 47 cases ineach group. There were 27 males and 20 females in the control group;they were (67.89±7.58) yearsold. There were 25 males and 22 females in the study group;they were (68.18±7.82) years old. Thecontrol group were given propofol 0.6-1.2 mg/kg for anesthesia induction and 4-10 mg•kg^(-1)•h^(-1) formaintenance. The study group were given remazolam 0.1-0.3 mg/kg for anesthesia induction andremazolam 0.8-1.2 mg•kg^(-1)•h^(-1) and remifentanil 0.1-0.2 μg•kg-1•min-1 for maintenance. The cardiacindexes (CI) and cardiac outputs (CO), mean artery pressures (MAP), and oxygen saturations (SpO2)were compared between the two groups before anesthesia induction (T_(0)), when anesthesiainduction succeeded (T_(1)), immediately after laryngeal mask placement (T_(2)), and 20 minutes aftersurgery (T_(3)). The rates and severities of postoperative nausea (PON), postoperative vomiting (POV),and postoperative nausea and vomiting (PONV) were compared between the two groups. Theanesthesia recovery indicators (awakening time, extubation time, and restlessness during recovery)were compared between the two groups. The χ^(2), t, and Mann-Whitney U tests were applied.Results The CI's at T_(1), T_(2), and T_(3) in the study group were higher than those in the control group[(2.89±0.43) min•m^(-2) vs. (2.64±0.41) min•m^(-2), (2.71±0.37) min•m^(-2) vs. (2.54±0.33) min•m^(-2), and(2.85±0.40) min•m^(-2) vs. (2.60±0.38) min•m^(-2)]. The CO's at T_(1), T_(2), and T_(3) in the study group werehigher than those in the control group [(5.26±0.47) L/min vs. (4.92±0.43) L/min, (4

关 键 词：瑞马唑仑 瑞芬太尼 老年麻醉 眼科手术 循环功能 术后恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]