不同剂量瑞马唑仑对腹腔镜膀胱癌根治术患者镇静深度和血流动力学指标的影响  

Effects of different doses of remazolam on sedation depth and hemodynamics in patients undergoing laparoscopic radical bladder cancer surgery

作　　者：年春苗[1] 田丹丹[1] 付琦[1] 吕慧敏[1] Nian Chunmiao;Tian Dandan;Fu Qi;Lyu Huimin(Department of Anesthesia and Perioperative Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院麻醉与围术期医学部,郑州450000

出　　处：《中国实用医刊》2023年第20期51-54,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨不同剂量瑞马唑仑对腹腔镜膀胱癌根治术患者镇静深度和血流动力学指标的影响。方法抽取2020年10月至2022年10月于郑州大学第一附属医院麻醉与围术期医学部行全身麻醉腹腔镜膀胱癌根治术患者110例,按抽签法分为两组,每组55例。麻醉诱导依次给予瑞马唑仑、舒芬太尼、罗库溴铵,术中低剂量组给予瑞马唑仑0.1 mg/(kg·h)静脉泵注及1.5%七氟醚吸入,高剂量组给予瑞马唑仑0.2 mg/(kg·h)静脉泵注及1.5%七氟醚吸入,直至手术结束。比较两组患者镇静深度、应激水平、血流动力学指标及并发症发生率。结果低剂量组苏醒时间、拔管时间、麻醉后监护室滞留时间少于高剂量组(P<0.05);麻醉前0.5 h,两组血清白细胞介素-6(IL-6)、血糖、C反应蛋白(CRP)水平比较,差异未见统计学意义(P>0.05);麻醉后12、24 h,低剂量组血清IL-6、血糖、CRP水平低于高剂量组(P<0.05)。两组脑电双频指数值≤60时(T1)平均动脉压(MAP)低于麻醉诱导开始时(T0),T1时心率(HR)高于T0时间点(P<0.05);两组各时间点MAP、HR比较差异未见统计学意义(P>0.05)。低剂量组并发症发生率(18.18%,10/55)低于高剂量组(21.82%,12/55),但差异未见统计学意义差异(P>0.05)。结论低剂量瑞马唑仑应用于腹腔镜膀胱癌根治术患者,镇静效果稳定,可在维持血流动力学稳定的条件下减轻应激反应,安全性较高。ObjectiveTo investigate the effect of different doses of remazolam on sedation depth and hemodynamics in patients undergoing laparoscopic radical surgery for bladder cancer.MethodsA total of 110 patients undergoing laparoscopic radical bladder cancer surgery requiring general anesthesia in Department of Anesthesiology and Perioperative Medicine of the First Affiliated Hospital of Zhengzhou University from October 2020 to October 2022 were selected.They were divided into two groups by drawing lot,with 55 cases in each group.Both groups were given remazolam,sufentanil and rocuronium in turn as anesthetic induction.During the operation,the low-dose group was given remazolam 0.1 mg/(kg·h)intravenous pump and 1.5%sevoflurane inhalation,while the high-dose group was given remazolam 0.2 mg/(kg·h)intravenous pump and 1.5%sevoflurane inhalation until the end of the operation.The depth of sedation,stress level,hemodynamics and complication rate were compared between the two groups.ResultsThe recovery time,extubation time and post anesthesia care unit retention time of the low-dose group were lower than those of the high-dose group(P<0.05).Half an hour before anesthesia,there were no significant differences in levels of serum interleukin-6,glucose,C-reactive protein between the two groups(P>0.05).The 12-and 24-hour postoperative levels of IL-6,glucose and C-reative protein in serum in the low-dose group were lower than those in the high-dose group(P<0.05).When the EEG dual-frequency index value was 60 or below(T1),mean arterial pressure(MAP)was lower than that at the beginning of anesthesia induction(T0),while heart rate(HR)at T1 was higher than that at T0 in the two groups(P<0.05).There were no significant differences in MAP and HR between the two groups at each time point(P>0.05).The incidence of complications in the low-dose group(18.18%,10/55)was slightly lower than that in the high-dose group(21.82%,12/55),but without significant difference(P>0.05).ConclusionsLow-dose remazolam has stable sedative effect in laparosco

关 键 词：膀胱癌 腹腔镜 瑞马唑仑 镇静深度 应激水平 

分 类 号：R737.14[医药卫生—肿瘤] R614[医药卫生—临床医学]