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机构地区:[1]广东医科大学附属佛山复星禅诚医院,528031
出 处:《浙江临床医学》2023年第8期1226-1228,共3页Zhejiang Clinical Medical Journal
基 金:广东省医院药学研究基金项目(新晨舒适化医疗专项基金项目)(2020XC31)。
摘 要:目的比较甲苯磺酸瑞马唑仑和丙泊酚对老年高血压患者全身麻醉诱导插管的有效性和安全性评价。方法择期插管全身麻醉的老年高血压患者54例,随机分为甲苯磺酸瑞马唑仑组(R组)和丙泊酚组(B组)。诱导时静脉注射芬太尼,2 min后R组和B组分别静脉滴注瑞马唑仑和丙泊酚,MOAA/S评分≤1时给予顺阿曲库铵,达到插管条件后气管插管。记录基线值(T0),给药后2 min(T1),插管前即刻(T2)和插管后1 min(T3)、3 min(T4)和5 min(T5)的平均动脉压(MAP)、心率(HR)、MOAA/S和Narcotrend指数(NI)、两组诱导期间相关指标,不良事件等。结果与T0比较,两组T1~5的MAP降低(P<0.05);与T0比较,两组T1和T5的HR减慢,T5的HR增快(P<0.05);与R组比较,B组T3的HR波动更小(P>0.05)。两组MOAA/S评分和NI诱导后下降(P<0.05),组间比较T1的NI B组低于R组(P<0.05)。麻黄碱总用量B组大于R组(P<0.05)。两组的镇静补救率、意识消失时间、麻醉诱导时间、不良反应组间比较无明显差异(P<0.05),均无术中知晓。结论0.3 mg/kg甲苯磺酸瑞马唑仑和1.5 mg/kg丙泊酚均可安全有效用于老年高血压患者麻醉诱导,其中甲苯磺酸瑞马唑仑对心率影响更小,升压药总用量更少。Objective To compare the effects of remazolam tosylate and propofol on sedation and hemodynamics in elderly patients with hypertension during induction intubation under general anesthesia.Methods Fifty-four elderly hypertensive undergoing selective operation under general anesthesia intubation were randomly divided into two groups.They were divided into the eemazolam tosylate group(group R)and the propofol group(group B).General anesthesia was induced with fentanyl injected intravenously in both groups.After 2 minutes,group R and group B were injected with remazolam tosylate and propofol.When MOAA/S value≤1,cis-atracurium was administered.Endotracheal intubation was performed after the intubation condition was confirmed.The MAP,HR,MOAA/S and NI values were recorded at the baseline(T0),2 min after administration(T1),immediately before intubation(T2),1 min(T3),3 min(T4)and 5 min(T5)after tracheal intubation.The related indicators during anesthesia induction,adverse events during the induction of anesthesia were recorded.Results Compared with T0,the MAP of T1~5 were decreased in two groups,with statistical significance(P<0.05).Compared with T0,HR were decreased at T1 and T5 in two groups(P<0.05),and at T3 were increased,with statistical significance(P<0.05).Compared with group R,HR were decreased in group B,but there was no statistical significance(P>0.05).The MOAA/S score and Narcotrend index of the two groups were decreased after induction(P<0.05),and the NI of T1 in the group B was lower than that in group R,with statistical significance(P<0.05).The total of ephedrine in group B was more than that in group R,with statistical significance(P<0.05).There were no significant differences in the percentage of using sedative rescue,the time of loss consciousness,the anesthesia induction time and adverse events between two groups(P<0.05).There was no intraoperative awareness in two groups.Conclusion Both 1.5 mg propofol and 0.3 mg/kg remazolam tosylate can be safely and effectively used for anesthesia induction in elde
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