瑞马唑仑与丙泊酚在老年经皮穿刺椎体成型手术中的麻醉效果比较  

Comparison of anesthesia remaazolam and propofol in effect of percutaneous vertebral molding of elderly

作　　者：凌钧渲 龙小丽 周爱静 LING Junxuan;LONG Xiaoli;ZHOU Aijing(Department of Anesthesiology,Yongkang City Sixth People's Hospital,Yongkang 321300,China)

机构地区：[1]永康市第六人民医院麻醉科,浙江永康321300

出　　处：《全科医学临床与教育》2023年第11期1003-1006,共4页Clinical Education of General Practice

基　　金：公益类金华市科学技术研究项目(2021-4-189)。

摘　　要：目的 比较老年经皮穿刺椎体成型手术中采取瑞马唑仑和丙泊酚进行麻醉的效果。方法 选取行经皮穿刺椎体成型手术的96例老年患者,按动态随机法将其分为观察组(n=48)和对照组(n=48)。观察组采用瑞马唑仑麻醉,对照组给予丙泊酚麻醉。比较两组麻醉效果相关指标,入手术室时(T_0)、麻醉诱导后手术开始时(T_1)、穿刺椎体时(T_2)、手术结束时(T_3)时血流动力学指标,麻醉诱导前30 min及术后24 h、72 h免疫功能指标(CD^(4+)、CD^(8+)、CD^(4+)/CD^(8+))以及不良反应情况。结果 观察组患者睫毛反射消失时间明显长于对照组,苏醒时间明显短于对照组(t分别=6.50、-6.71,P均<0.05);观察组T_1、T_2、T_3时平均动脉压(MAP)水平低于对照组(t分别=5.41、6.41、4.87,P均<0.05),T1、T2时心率(HR)值低于对照组(t分别=5.94、6.47,P均<0.05);术后24 h观察组CD^(4+)、CD^(4+)/CD^(8+)比值均高于对照组(t分别=6.41、2.40,P均<0.05);两组患者不良反应总发生率比较相当,差异无统计学意义(χ~2=0.12,P>0.05)。结论 瑞马唑仑用于老年经皮穿刺椎体成型手术与丙泊酚相比,麻醉效果更强,对血流动力学影响更小,且对细胞免疫的抑制程度较轻,有一定的安全性。Objective To compare the anesthesia effect of remazolam and propofol in percutaneous vertebroplasty of the elderly.Methods Ninety six elderly patients undergoing percutaneous vertebroplasty were randomly divided into control group(n=48)and observation group(n=48).The control group was anesthetized with propofol,and the observa-tion group was anesthetized with remazolam.The indexes related to anesthesia effect,hemodynamic indexes at the time of entering the operating room(T0),the beginning of surgery after anesthesia induction(T1),the time of vertebral puncture(T2),the end of surgery(T3),immune function indicators(CD4+,CD8+,CD4+/CD8+)at 30 minutes before anesthesia,and 24 h,72 h after surgery,adverse reactions between the two groups were compared.Results The disappearance time of eyelash reflex in the observation group was significantly longer than that in the control group,and the recovery time was significantly shorter than that in the control group(t=6.50,-6.71,P<0.05).The increase of MAP level at T1,T2 and T3 in the observation group was lower than that in the control group(t=5.41,6.41,4.87,P<0.05),and HR at T1 and T2 was lower than that in the control group(t=5.94,6.47,P<0.05).At 24 hours after operation,the ratio of CD4+and CD4+/CD8+in the observation group was higher than that in the control group(t=6.41,2.40,P<0.05).The overall incidence of adverse reactions in the two groups was comparable,the difference was not statistically significant(χ2=0.12,P>0.05).Conclusion Compared with propofol,remazolam used in percutaneous vertebroplasty in the elderlyhas has stronger anes-thetic effect,less impact on hemodynamics,and less inhibition on cellular immunity,so it is safe to some extent.

关 键 词：瑞马唑仑 丙泊酚 经皮穿刺椎体成型术 血流动力学 

分 类 号：R614[医药卫生—麻醉学]