不同剂量瑞马唑仑全麻诱导在老年患者手术中的应用及对血流动力学的影响分析  

Application of Different Doses of Rimazolam for Induction of General Anesthesia in Elderly Patients in Surgery and Analysis of its Hemodynamic Effects

作　　者：王华彩 徐国兴[1] Wang Huacai;Xu Guoxing(Department of Surgery,Department of Anesthesia and Perioperative Medicine,The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan,473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院麻醉与围术期医学科手术部,河南南阳473000

出　　处：《黑龙江医学》2023年第23期2847-2850,共4页Heilongjiang Medical Journal

基　　金：河南省医学科技攻关项目(201800265)。

摘　　要：目的:探讨不同剂量瑞马唑仑全麻诱导在老年患者手术中的临床价值。方法:选取2020年4月—2021年8月135例接受腹腔镜手术治疗的老年患者作为研究对象,随机分为低剂量组(接受0.3 mg/kg瑞马唑仑全麻诱导,67例)与高剂量组(接受0.4 mg/kg瑞马唑仑全麻诱导,68例);对比两组患者手术不同时间的平均动脉压(MAP)、匹兹堡睡眠质量指数(PSQI)、一氧化氮(NO)、心率(HR)、肾上腺皮质激素(ACTH)、简易精神状态评价量表(MMSE)、血氧饱和度(SaO_(2))情况。结果:诱导30 min后低剂量组的SaO_(2)、MAP高于高剂量组,HR低于高剂量组,差异有统计学意义(t=6.321、3.125、3.450,P<0.05);术后2 d低剂量组的ACTH、NO、PSQI评分低于高剂量组,MMSE评分高于高剂量组,差异有统计学意义(t=3.989、5.319、6.498、10.275,P<0.05)。结论:0.3 mg/kg剂量的瑞马唑仑在老年患者手术中全身麻醉诱导效果优于0.4 mg/kg,患者术中血液动力学稳定性更好且手术应激更小。Objective:To investigate the clinical value of induction of general anesthesia with different doses of rimazolam in elderly patients undergoing surgery.Methods:135 elderly patients treated with laparoscopic surgery from April 2020 to August 2021 were randomly selected and divided into a low-dose group(receiving 0.3 mg/kg rimazolam for general anesthesia induction,67 patients)and a high-dose group(receiving 0.4 mg/kg rimazolam for general anesthesia induction,68 patients).The mean arterial pressure(MAP),Pittsburgh Sleep Quality Index(PSQI),nitric oxide(NO),heart rate(HR),adrenocorticotropic hormone(ACTH),Simple Mental State Evaluation Scale(MMSE),and oxygen saturation(SaO_(2))at different times of the procedure were compared.Results:After 30 min of induction,SaO_(2) and MAP were higher in the low-dose group than in the high-dose group,and HR was lower than in the high-dose group,with statistically significant differences(t=6.321,3.125,3.450,P<0.05).ACTH,NO,and PSQI scores were lower in the low-dose group than in the high-dose group and MMSE scores were higher than in the high-dose group at 2 d postoperatively,with statistically significant differences(t=3.989,5.319,6.498,10.275,P<0.05).Conclusion:A dose of 0.3 mg/kg of rimazolam induced general anesthesia better than 0.4 mg/kg in elderly patients during surgery,with better intraoperative hemodynamic stability and less surgical stress.

关 键 词：全身麻醉 麻醉诱导 腹腔镜手术 血液动力学 

分 类 号：R614[医药卫生—麻醉学]