瑞马唑仑对全麻下老年全髋关节置换术患者血流动力学、认知功能的影响  

Effects of Remazolam on Hemodynamics and Cognitive Function in El⁃derly Patients Undergoing Total Hip Arthroplasty Under General Anesthe⁃sia

作　　者：苏慧 王飞[1] SU Hui;WANG Fei(Department of Anesthesiology,Xuzhou Cancer Hospital,Xuzhou 221000,Jiangsu,China)

机构地区：[1]徐州市肿瘤医院麻醉科,江苏徐州221000

出　　处：《系统医学》2024年第17期55-59,共5页Systems Medicine

摘　　要：目的分析全髋关节置换术中应用瑞马唑仑实施全身麻醉对老年患者的血流动力学、认知功能的影响。方法回顾性选取2021年3月—2023年3月在徐州市肿瘤医院行全髋关节置换术的86例老年患者的临床资料,根据麻醉诱导方案的不同分组,每组43例。观察组采用瑞马唑仑联合舒芬太尼、苯磺顺阿曲库铵进行麻醉诱导,采用瑞芬太尼与瑞马唑仑麻醉维持。对照组采用丙泊酚联合舒芬太尼、苯磺顺阿曲库铵麻醉诱导,采用瑞芬太尼与丙泊酚维持麻醉。比较两组血流动力学指标、认知功能、手术应激指标、术后恢复情况及不良反应发生率。结果观察组在脑电双频指数<60时以及插管后的心率、平均动脉压优于对照组,差异有统计学意义(P均<0.05)。术后,观察组认知功能评分高于对照组,手术应激指标水平均低于对照组,睁眼时间、拔管时间、复苏室停留时间短于对照组,差异有统计学意义(P均<0.05)。观察组不良反应总发生率为4.65%(2/43),低于对照组的18.60%(8/43),差异有统计学意义(χ^(2)=4.074,P<0.05)。结论在全身麻醉老年全髋关节置换术患者中应用瑞马唑仑,能稳定患者血流动力学指标,减轻手术应激反应,加快术后恢复速度,改善认知功能,且安全性较高。Objective To analyze the effects of general anesthesia administered with remazolam during total hip ar-throplasty on hemodynamics and cognitive function in elderly patients.Methods The clinical data of eighty-six el-derly patients who underwent total hip arthroplasty in Xuzhou Cancer Hospital from March 2021 to March 2023 were retrospectively selected.They were grouped according to the different anesthesia induction protocols,with forty-three cases in both groups.The observation group used remazolam combined with sufentanil and phenylsulfonyl cisatracu-rium for anesthesia induction,and anesthesia maintenance with remifentanil and remazolam.In the control group,an-esthesia was induced by propofol combined with sufentanil and benzenesulfonium cisatracurium,and anesthesia was maintained by remafentanil with propofol.Hemodynamic indexes,surgical stress indexes,postoperative recovery and incidence of adverse reactions were compared between the two groups.Results The observation group's heart rate and mean arterial pressure at EEG dual frequency index<60 and after intubation were better than those of the control group,and the differences were statistically significant(all P<0.05).After the operation,the cognitive function,scores of the observation group were higher than those of the control group,the levels of surgical stress indicators of the obser-vation group were all lower than those of the control group,and the eye-opening time,extubation time,and resuscita-tion room stay time of the observation group were shorter than those of the control group,and the differences were sta-tistically significant(all P<0.05).The total incidence of adverse reactions in the observation group was 4.65%(2/43),which was lower than 18.60%(8/43)in the control group,and the difference was statistically significant(χ^(2)=4.074,P<0.05).Conclusion Application of remazolam in general anesthesia elderly patients undergoing total hip arthroplasty stabilizes patients'hemodynamic indexes,reduces surgical stress,accelerates postoperative recovery

关 键 词：全髋关节置换术 瑞马唑仑 丙泊酚 全身麻醉 血流动力学 认知功能 

分 类 号：R614[医药卫生—麻醉学]