瑞马唑仑对腰椎减压融合术患者术后早期恢复质量的影响  

Effect of remimazolam on the quality of early postoperative recovery in patients undergoing lumbar decompression and fusion

作　　者：钟浩翔 王悦 杨俊塔 汪飞[2] ZHONG Haoxiang;WANG Yue;YANG Junta;WANG Fei(Shantou University Medical College,Shantou 515041,China;Department of Anesthesiology,Huizhou First People's Hospital,Huizhou 516000,China)

机构地区：[1]汕头大学医学院,广东汕头515041 [2]惠州市第一人民医院麻醉科,广东惠州516000

出　　处：《汕头大学医学院学报》2024年第4期217-222,共6页Journal of Shantou University Medical College

摘　　要：目的:探讨瑞马唑仑与丙泊酚对全身麻醉腰椎减压融合术患者术后早期恢复质量的影响。方法:选取2023年12月—2024年6月期间在惠州市第一人民医院择期接受全身麻醉下腰椎减压融合术的92例患者为研究对象,根据使用的不同麻醉药物,采用随机数字表法分为瑞马唑仑组(45例)和丙泊酚组(47例)。瑞马唑仑组男18例,女27例,年龄(62.4±6.8)岁;丙泊酚组男16例,女31例,年龄(62.7±8.1)岁。瑞马唑仑组麻醉诱导静脉注射瑞马唑仑6.0 mg/kg和舒芬太尼0.3μg/kg,麻醉维持静脉泵注瑞马唑仑0.5~1.0 mg·kg^(-1)·h^(-1)和瑞芬太尼0.1~0.2μg·kg^(-1)·min^(-1);丙泊酚组麻醉诱导静脉注射丙泊酚1~2 mg/kg和舒芬太尼0.3μg/kg,麻醉维持静脉泵注丙泊酚4~12 mg·kg^(-1)·h^(-1)和瑞芬太尼0.1~0.2μg·kg^(-1)·min^(-1)。主要观察指标为术后的15项恢复质量评分量表(15-item quality of recovery,QoR-15)评分情况。次要观察指标包括麻醉前5min (T_(0))、插管后1 min (T_(1))、手术切皮开始(T_(2))、手术后30 min (T_(3))、手术结束(T_(4))、拔管即刻(T_(5))、离开麻醉恢复室时(T_(6))的心率、平均动脉压和脑电双频指数,术中血管活性药的使用情况、麻醉恢复室苏醒时间、拔除气管导管时间、拔管后Richmond躁动-镇静评分(Richmond Agitation and Sedation Scale,RASS)等。结果:瑞马唑仑组在术后第1天和第3天的QoR-15评分分别为(114.1±7.2)分和(128.7±5.1)分,丙泊酚组分别为(112.8±7.8)分和(127.5±4.4)分,两组间差异无统计学意义(均P>0.05)。与丙泊酚组比较,瑞马唑仑组在T_(1)~T_(3)时心率增快,在T_(4)时平均动脉压升高,在T_(1)~T_(5)时脑电双频指数升高(均P<0.05)。瑞马唑仑组的术中血管活性药物使用率为22.2%(10/45),低于丙泊酚组的51.1%(24/47)(P<0.05)。瑞马唑仑组的苏醒时间和拔管时间分别为15 (11,18) min和16 (12,19) min,均长于丙泊酚组的11 (8,14) min和12 (10,15) min(均P<0.05)。瑞马唑仑组Objective:To investigate the effects of remimazolam and propofol on the quality of early postoperative recovery in patients undergoing lumbar decompression and fusion under general anesthesia.Methods:A total o92 patients who underwent lumbar decompression and fusion under general anesthesia in Huizhou First People's Hospital from December 2023 to June 2024 were selected as the research subjects.According to the different anesthetic drugs used,they were divided into remimazolam group(45 cases) and propofol group(47 cases) by random number table method.There were 18 males and 27 females in the remimazolam group,with an age of(62.4±6.8) years old;there were 16 males and 31 females in the propofol group,with an age of(62.7±8.1) years old.In the remimazolam group,6.0 mg/kg remimazolam and 0.3μg/kg sufentanil were intravenously injected for anesthesia induction,and 0.5-1.0 mg·kg~(-1)·h~(-1)remimazolam and 0.1-0.2μg·kg~(-1)·min~(-1)remimazolam were intravenously infused for anesthesia maintenance;in the propofol group,1-2 mg/kg propofol and 0.3μg/kg sufentanil were intravenously infused for anesthesia induction,and 4-12 mg·kg~(-1)·h~(-1)propofol and 0.1-0.2μg·kg~(-1)·min~(-1)remimazolam were intravenously infused for anesthesia maintenance.The main outcome measure was the postoperative 15-item quality of recovery(QoR-15) score.Secondary outcome measures included heart rate,mean arterial pressure,and bispectral index 5 minutes before anesthesia(T_0),1 minute after intubation(T_1)start of surgical skin incision(T_2),30 minutes after surgery(T_3),end of surgery(T_4),immediate extubation(T_5),and leaving the postanesthesia care unit(T_6),the use of vasoactive drugs during surgery,the time of awakening in the postanesthesia care unit,the time of extubation,and the Richmond Agitation and Sedation Scale(RASS) score after extubation.Results:The QoR-15 scores of the remimazolam group on the first and third days after surgery were(114.1±7.2) and(128.7±5.1),respectively,and those of the propofol group were(112.8±7

关 键 词：腰椎减压融合 瑞马唑仑 丙泊酚 术后恢复 

分 类 号：R614.2[医药卫生—麻醉学]