瑞马唑仑复合腰丛-坐骨神经联合阻滞对老年股骨粗隆间骨折手术患者的影响  

Effect of Remazolam Anesthesia Combined Lumbar-Plexus and Sciatic-Nerve Block in Elderly Patients Undergoing Surgery for Intertrochanteric Femoral Fractures

作　　者：张秋莹 李立明 ZHANG Qiuying;LI Liming(Anesthesia Department,Jiaozuo Coal Industry(Group)Limited Liability Company Central Hospital,Jiaozuo 454000,China)

机构地区：[1]焦作煤业(集团)有限责任公司中央医院麻醉科,河南焦作454000

出　　处：《河南医学研究》2023年第24期4517-4520,共4页Henan Medical Research

摘　　要：目的探讨瑞马唑仑复合腰丛-坐骨神经联合阻滞对老年股骨粗隆间骨折(IFF)手术患者的影响。方法选取2019年1月至2022年1月于焦作煤业(集团)有限责任公司中央医院接受IFF手术治疗的91例老年患者,按照随机数字表法分为对照组(46例)、观察组(45例),对照组接受丙泊酚全身麻醉,观察组接受瑞马唑仑复合腰丛-坐骨神经联合阻滞麻醉,比较两组不同时间血流动力学变化、术前及术后2 h免疫功能及认知功能情况。结果手术前30 min(T_(0)),两组患者心率(HR)及平均动脉压(MAP)比较,差异无统计学意义(P>0.05);开始手术时(T_(1))、结束手术时(T_(2))、结束手术后2 h(T_(3)),观察组HR及MAP均较对照组高(P<0.05);T_(3)时,两组外周血CD4^(+)及CD4^(+)/CD8^(+)水平、IFF手术患者蒙特利尔认知量表(MoCA)评分、简易精神状态量表(MMSE)评分较术前降低,且观察组较对照组高(P<0.05)。结论瑞马唑仑复合腰丛-坐骨神经联合阻滞麻醉用于老年IFF手术患者中,可以稳定其血流动力学,且术后对免疫功能及认知功能影响较小,可进一步在临床上推广应用。Objective To discuss the effect of remazolam anesthesia combined lumbar-plexus and sciatic-nerve block in elderly patients undergoing surgery for intertrochanteric femoral fractures(IFF).Methods Ninety-one elderly IFF patients in Anesthesia Department,Jiaozuo Coal Industry(Group)Limited Liability Company Central Hospital from January 2019 to January 2022 were enrolled,and they were divided into control group(46 cases)and observation group(45 cases)by random number table method.The control group received general anesthesia with propofol,while observation group received remazolam anesthesia combined lumbar-plexus and sciatic-nerve block.The hemodynamic parameters at different surgical times,as well as the immune function and cognitive function parameters before and 2 hours after surgery were compared between two groups.Results The heart rate(HR)and mean arterial pressure(MAP)at 30 minutes before surgery(T_(0))had no statistical difference between two groups(P>0.05),while the HR and MAP values at the beginning of surgery(T_(1)),the end of surgery(T_(2))and 2 hours after surgery(T_(3))were higher in observation group than in control group(P<0.05).At T_(3),peripheral blood CD4^(+)and CD4^(+)/CD8^(+)values,Montreal cognitive assessment(MoCA)and mini-mental state examination(MMSE)scores in both groups declined than before surgery,and observation group was higher than control group(P<0.05).Conclusion Application of remazolam anesthesia combined lumbar-plexus and sciatic-nerve block in elderly patients undergoing surgery for IFF can stabilize hemodynamics and has less impact on immune function and cognitive function in the postoperative period,which is worthy of recommendation.

关 键 词：瑞马唑仑 腰丛-坐骨神经阻滞 股骨粗隆间骨折手术 免疫功能 

分 类 号：R614.4[医药卫生—麻醉学]