甲苯磺酸瑞马唑仑联合小剂量丙泊酚麻醉诱导对老年LC患者应激反应的影响  

Effects of remimazolam toluenesulfonate combined with low-dose propofol anesthesia induction on stress response in elderly patients with LC

作　　者：毛萍静 邢凡 徒功兵 查文华 丰陈 MAO Pingjing;XING Fan;TU Gongbing;ZHA Wenhua;FENG Chen(Nanjing Lishui District People’s Hospital,Lishui Branch of Zhongda Hospital Affiliated to Southeast University,Nanjing 211200,Jiangsu,China)

机构地区：[1]南京市溧水区人民医院、东南大学附属中大医院溧水分院,江苏南京211200

出　　处：《中南医学科学杂志》2024年第2期258-260,271,共4页Medical Science Journal of Central South China

基　　金：南京市卫生科技发展项目(YKK20180)。

摘　　要：目的探讨甲苯磺酸瑞马唑仑联合小剂量丙泊酚麻醉诱导对老年腹腔镜胆囊切除术(LC)患者应激反应的影响。方法选取行LC老年患者103例,随机分为对照组(51例,常规剂量丙泊酚)和观察组(52例,甲苯磺酸瑞马唑仑+小剂量丙泊酚)。比较两组麻醉效果及不同时间点血气指标[pH、动脉血CO_(2)分压(PaCO_(2))、动脉血氧分压(PaO_(2))]、应激水平[血浆皮质醇(PC)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]及不良事件发生情况。结果观察组诱导起效时间慢于对照组(P<0.05),两组唤醒时间、离室时间及不同时间点血气指标比较,差异无显著性(P>0.05)。手术结束时,观察组PC、TNF-α、CRP水平低于对照组(P<0.05)。观察组低血压、心动过缓、低氧血症及注射痛发生率明显低于对照组(P<0.05)。结论甲苯磺酸瑞马唑仑联合小剂量丙泊酚用于老年LC患者麻醉效果良好,可有效稳定其血气指标,抑制应激反应,且安全性优于丙泊酚单独使用。Aim To Explore the effect of remimazolam toluenesulfonate combined with low-dose propofol anesthesia induction on stress response in elderly patients undergoing laparoscopic cholecystectomy(LC).Methods 103 elderly patients undergoing LC were selected and randomly divided into a control group(51 cases,conventional dose propofol)and an observation group(52 cases,remimazolam toluenesulfonate+low-dose propofol).Comparison of anesthesia effects and blood gas indicators at different time points between two groups(pH,arterial CO_(2)partial pressure(PaCO_(2)),arterial oxygen partial pressure(PaO_(2))),stress levels(plasma cortisol(PC),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and occurrence of adverse events).Results The induction onset time of the observation group was slower than that of the control group(P<0.05).There was no significant difference in wake-up time and departure time between the two groups(P>0.05).At the end of the surgery,PC,TNF-α,and CRP level in the observation group was lower than that of the control group(P<0.05).The incidence of hypotension,bradycardia,hypoxemia,and injection pain in the observation group was significantly lower than that in the control group(P<0.05).Conclusion The combination of remazolam toluenesulfonate and low-dose propofol has a good anesthetic effect on elderly LC patients,which can effectively stabilize their blood gas indicators,inhibit stress reactions,and is safer than propofol alone.

关 键 词：腹腔镜胆囊切除术 甲苯磺酸瑞马唑仑 丙泊酚 应激反应 

分 类 号：R657.4[医药卫生—外科学]