瑞马唑仑和丙泊酚用于老年脑膜瘤患者的临床研究  

Clinical trial of remazolam and propofol in the treatment of elderly patients with meningioma

作　　者：李锦汶 章文斌[2] 吴姗姗[1] 陆军[1] LI Jin-wen;ZHANG Wen-bin;WU Shan-shan;LU Jun(Department of Anesthesiology,Nanjing Brain Hospital/Nanjing Medical University Affiliated Brain Hospital,Nanjing 210000,Jiangsu Province,China;Department of Neurosurgery,Nanjing Brain Hospital/Nanjing Medical University Affiliated Brain Hospital,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]南京脑科医院/南京医科大学附属脑科医院麻醉科,江苏南京210000 [2]南京脑科医院/南京医科大学附属脑科医院神经外科,江苏南京210000

出　　处：《中国临床药理学杂志》2024年第23期3390-3394,共5页The Chinese Journal of Clinical Pharmacology

基　　金：江苏省科技计划专项资金重点基金资助项目(BE2022049)。

摘　　要：目的比较瑞马唑仑注射剂和丙泊酚注射液全身麻醉在老年脑膜瘤手术中的临床疗效及安全性。方法将老年脑膜瘤患者按随机数表法分为对照组和试验组。试验组静脉注射0.2~0.3 mg·kg^(-1)瑞马唑仑、0.5~1.0μg·kg^(-1)瑞芬太尼、0.3μg·kg^(-1)舒芬太尼、0.2 mg·kg^(-1)顺式阿曲库铵进行麻醉诱导;对照组静脉注射1~2 mg·kg^(-1)丙泊酚、0.5~1.0μg·kg^(-1)瑞芬太尼、0.3μg·kg^(-1)舒芬太尼、0.2 mg·kg^(-1)顺式阿曲库铵进行麻醉诱导。试验组静脉泵注0.4~1.0 mg·kg^(-1)·h^(-1)瑞马唑仑、0.05~0.20μg·kg^(-1)·min^(-1)瑞芬太尼进行麻醉维持;对照组静脉泵注4~10 mg·kg^(-1)·h^(-1)丙泊酚、0.05~0.20μg·kg^(-1)·min^(-1)瑞芬太尼进行麻醉维持。比较2组患者围术期的血流动力学、疼痛情况、苏醒质量、麻醉药物使用,以及安全性。结果试验组入组71例,脱落3例,最终有68例纳入统计分析;对照组入组70例,脱落1例,最终有69例纳入统计分析。试验组与对照组剪开硬脑膜时(T1)的平均动脉压分别为(107.74±6.55)和(116.06±7.04)mmHg,T1时的心率分别为(80.09±3.87)和(84.33±4.02)beat·min^(-1),在统计学上差异均有统计学意义(均P<0.05)。试验组与对照组术后12 h的疼痛视觉模拟量表(VAS)评分分别为(2.99±0.40)和(3.25±0.47)分,术后24 h的VAS评分分别为(2.56±0.50)和(2.83±0.38)分,在统计学上差异均有统计学意义(均P<0.05)。试验组与对照组的苏醒时间分别为(15.99±1.63)和(20.83±2.05)min,拔管时间分别为(17.01±1.53)和(21.09±1.95)min,术中瑞芬太尼用量分别为(851.34±79.25)和(942.26±90.28)μg,在统计学上差异均有统计学意义(均P<0.05)。试验组的药物不良反应主要有低血压、心动过缓,对照组的药物不良反应主要有低血压、心动过缓、呼吸抑制。试验组和对照组的总药物不良反应发生率分别为7.35%和18.84%,在统计学上差异有统计学意义(P<0.05)。结论瑞马唑仑注射�Objective To compare the clinical efficacy and safety of remazolam injection and propofol injection general anesthesia in the operation of senile meningioma.Methods The elderly patients with meningioma were divided into control group and treatment group according to random number table method.The treatment groups were given intravenous injection of 0.2-0.3 mg·kg^(-1)remazolam,0.5-1.0μg·kg^(-1)remifentanil,0.3μg·kg^(-1)sufentanil,0.2 mg·kg^(-1)cisatracurium for anesthesia induction.The control group was anesthetised by intravenous injection of 1-2 mg·kg^(-1)propofol,0.5-1.0μg·kg^(-1)remifentanil,0.3μg·kg^(-1)sufentanil and 0.2 mg·kg^(-1)cisatracurium.The treatment groups were injected with 0.4-1.0 mg·kg^(-1)·h^(-1) remazolam and 0.05-0.20μg·kg^(-1)·min^(-1)remifentanil by intravenous pump for anesthesia maintenance.The control group was treated with 4-10 mg·kg^(-1)·h^(-1) propofol and 0.05-0.20μg·kg^(-1)·min^(-1)remifentanil by intravenous pump.The hemodynamics,pain,recovery quality,use of anesthetic drugs and the safety were compared between the two groups.Results In the treatment group,71 cases were enrolled,3 cases fell off,and 68 cases were included in the statistical analysis.In the control group,70 cases were enrolled,1 case was shed,and finally 69 cases were included in statistical analysis.The mean arterial pressure at the end of dural incision(T1)in treatment group and control group was(107.74±6.55)and(116.06±7.04)mmHg,heart rates at T1 were(80.09±3.87)and(84.32±4.02)beat·min^(-1),the differences were statistically significant(all P<0.05).The pain visual analog scale scores of treatment and control groups at 12 h after surgery were(2.99±0.40)and(3.25±0.47)points,at 24 h after surgery were(2.56±0.50)and(2.83±0.38)points,the differences were statistically significant(all P<0.05).The recovery time of treatment group and control group was(15.99±1.63)min and(20.83±2.05)min,the extubation time was(17.01±1.53)and(21.09±1.95)min,the dosage of remifentanil was(851.34±79.25)and(9

关 键 词：瑞马唑仑注射剂 丙泊酚注射液 老年 脑膜瘤手术 效果 

分 类 号：R971.2[医药卫生—药品]