不同剂量瑞马唑仑复合罗哌卡因腰-硬联合阻滞对老年髋关节置换术患者的影响  

Effects of Different Doses of Remazolam Combined with Ropivacaine for Combined Spinal-epidural Anesthesia in Elderly Patients Undergoing Hip Replacement

作　　者：陈清瑞 刘雨林 苏长生 朱国绍 李顺元[1] CHEN Qingrui;LIU Yulin;SU Changsheng;ZHU Guoshao;LI Shunyuan(Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362002,China;不详)

机构地区：[1]福建医科大学附属泉州第一医院,福建泉州362002 [2]永春县医院

出　　处：《中外医学研究》2024年第2期137-141,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨不同剂量瑞马唑仑复合罗哌卡因腰-硬联合阻滞对老年髋关节置换术患者的影响。方法:选择2022年6月—2023年4月福建医科大学附属泉州第一医院接诊的103例老年髋关节置换术患者作为研究对象,将其随机分为R2组(n=51)、R4组(n=52)。R2组术中给予2μg/(kg·min)瑞马唑仑复合罗哌卡因,R4组术中给予4μg/(kg·min)瑞马唑仑复合罗哌卡因。比较两组术中镇静深度[脑电双频指数(BIS)、改良警觉镇静评分(MOAA/S)]、术后疼痛评分、镇静起效时间、镇静补救次数、苏醒时间、血流动力学指标[平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))]及不良反应发生情况。结果:两组MOAA/S评分、BIS、MAP、SpO_(2)、HR组间、时间点及交互比较,差异有统计学意义(P<0.05);镇静后5 min、20 min、45 min,R2组BIS、MOAA/S评分、MAP、SpO_(2)、HR均高于R4组,差异有统计学意义(P<0.05)。R2组镇静起效时间长于R4组,苏醒时间短于R4组,镇静补救次数多于R4组,差异有统计学意义(P<0.05)。两组VAS评分组间、时间点及交互比较,差异无统计学意义(P>0.05);术后6 h、12 h、24 h,两组疼痛模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05)。R2组不良反应总发生率为19.61%,低于R4组的71.15%,差异有统计学意义(P<0.05)。结论:不同剂量瑞马唑仑复合罗哌卡因腰-硬联合阻滞对老年髋关节置换术患者镇痛效果无明显差异,但选用小剂量麻醉患者苏醒时间更短,既能满足镇静深度,又能保证术中安全性及血流动力学指标平稳,且不良反应更少。Objective:To investigate the effect of different doses of Remazolam combined with Ropivacaine spinal-epidural anesthesia on elderly patients undergoing hip replacement.Method:A total of 103 elderly patients with hip replacement admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from June 2022 to April 2023 were selected as the study objects and randomly divided into R2 group(n=51)and R4 group(n=52).The R2 group was given 2μg/(kg·min)Remazolam combined with Ropivacaine,and the R4 group was given 4μg/(kg·min)Remazolam combined with Ropivacaine.The depth of sedation[bispectral index(BIS),modified observational assessment of alertness and sedation(MOAA/S)],postoperative pain score,duration of sedation onset,number of sedation recovery,recovery time,hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO_(2))]and the occurrence of adverse reactions were compared between the two groups.Result:There were statistically significant differences in the comparison of MOAA/S score,BIS,MAP,SpO_(2),HR between-group,time points,and interactions between the two groups(P<0.05).At 5 min,20 min and 45 min after sedation,BIS,MOAA/S score,MAP,SpO_(2) and HR in R2 group were higher than those in R4 group,and the differences were statistically significant(P<0.05).The onset time of sedation in R2 group was longer than that in R4 group,the recovery time was shorter than that in R4 group,and the number of sedation recovery was higher than that in R4 group,the differences were statistically significant(P<0.05).There were no statistically significant differences in pain analogue scale(VAS)scores between the two groups at different group,time points and interactions(P>0.05).There were no significant differences in VAS scores between the two groups at 6 h,12 h and 24 h after surgery(P>0.05).The total incidence of adverse reactions in R2 group was 19.61%,which was lower than 71.15%in R4 group,and the difference was statistically significant(P<0.05).Conclusion:Different doses of Rem

关 键 词：剂量 瑞马唑仑 罗哌卡因 髋关节置换 

分 类 号：R614[医药卫生—麻醉学]