瑞马唑仑在胸腔镜下肺叶切除术患者中的应用效果及对术后急慢性疼痛、血清创伤应激指标的影响  

Application effect of remimazolam in patients undergoing thoracoscopic lobectomy and its influences on postoperative acute and chronic pain and serum traumatic stress indicators

作　　者：吕玉珠 柴伟 李艳 LYU Yuzhu;CHAI Wei;LI Yan(Anesthesia Surgery Center,Xi'an International Medical Center Hospital,Xi'an 710100,China)

机构地区：[1]西安国际医学中心医院麻醉手术中心,陕西西安710100

出　　处：《临床医学研究与实践》2023年第36期70-73,共4页Clinical Research and Practice

摘　　要：目的分析瑞马唑仑在胸腔镜下肺叶切除术患者中的应用效果及对术后急慢性疼痛、血清创伤应激指标的影响。方法选取2022年6月至12月我院收治的120例行胸腔镜下肺叶切除术治疗患者为研究对象,随机将其分为常规组(60例,以丙泊酚进行全身麻醉)和观察组(60例,以瑞马唑仑进行全身麻醉)。比较两组的麻醉效果。结果麻醉诱导前,两组的疼痛阈值无显著差异(P>0.05);麻醉诱导后,两组的疼痛阀值均升高,且观察组高于常规组,差异具有统计学意义(P<0.05)。术后12 h,两组的视觉模拟评分法(VAS)评分无显著差异(P>0.05);术后第3天,两组的VAS评分均降低,且观察组低于常规组,差异具有统计学意义(P<0.05)。术后,观察组的β-内啡肽(β-EP)、神经肽Y(NPY)、前列腺素E_(2)(PGE_(2))、髓过氧化物酶(MPO)水平低于常规组,差异具有统计学意义(P<0.05)。观察组的心动过缓、呼吸抑制及恶心呕吐发生率低于常规组,差异具有统计学意义(P<0.05)。结论在胸腔镜下肺叶切除术患者中应用瑞马唑仑进行全身麻醉,可有效提高患者的术中疼痛阈值,减轻术后慢性疼痛,降低术后创伤性应激反应,且不会产生严重呼吸抑制、循环抑制,从而取得安全、高效的麻醉效果。Objective To analyze the application effect of remimazolam in patients undergoing thoracoscopic lobectomy and its influences on postoperative acute and chronic pain and serum traumatic stress indicators.Methods A total of 120 patients who underwent thoracoscopic lobectomy in our hospital from June to December 2022 were selected as the research objects.The patients were randomly divided into routine group(60 cases,general anesthesia with propofol)and observation group(60 cases,general anesthesia with remimazolam).The anesthetic effects of the two groups were compared.Results Before anesthesia induction,there was no significant difference in pain threshold between the two groups(P>0.05);after anesthesia induction,the pain thresholds of the two groups increased,that in the observation group was higher than the routine group,and the difference was statistically significant(P<0.05).At 12 h after operation,there was no significant difference in Visual Analogue Scale(VAS)score between the two groups(P>0.05);on the third day after operation,the VAS score of the two groups decreased,that in the observation group was lower than the routine group,and the difference was statistically significant(P<0.05).After operation,the levels ofβ-endorphins(β-EP),neuropeptide Y(NPY),prostaglandin E_(2)(PGE_(2))and myeloperoxidase(MPO)in the observation group were lower than those in the routine group,and the differences were statistically significant(P<0.05).The incidences of bradycardia,respiratory depression,nausea and vomiting in the observation group were lower than those in the routine group,and the differences were statistically significant(P<0.05).Conclusion The application of remimazolam for general anesthesia in patients undergoing thoracoscopic lobectomy can effectively improve the patients'intraoperative pain threshold and reduce postoperative chronic pain,decrease postoperative traumatic stress response,and will not produce severe respiratory depression and circulatory inhibition,so as to achieve safe and efficient anesthes

关 键 词：胸腔镜下肺叶切除术 全身麻醉 瑞马唑仑 疼痛 应激反应 

分 类 号：R614[医药卫生—麻醉学]