术中持续泵注苯磺酸瑞马唑仑对老年脊柱骨折患者术后谵妄的影响  

Effect of Intraoperative Continuous Pumping of Remazolam Besylate on Postoperative Delirium in Elderly Patients with Spinal Fracture

作　　者：袁锦强 梁亚贵 翁迪贵 YUAN Jinqiang;LIANG Yagui;WENG Digui(Department of Anesthesiology,Mindong Hospital of Ningde City,Fu'an 355000,Fujian,China)

机构地区：[1]宁德市闽东医院麻醉科,福建福安355000

出　　处：《中国药物滥用防治杂志》2024年第12期2181-2183,共3页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：福建省自然科学基金项目(编号:2023J011912)。

摘　　要：目的:研究术中持续泵注苯磺酸瑞马唑仑对老年脊柱骨折患者术后谵妄的影响。方法:选取本院2023年5月—2024年5月收治的82例老年脊柱骨折患者,按照术中维持麻醉方式分为对照组(n=40)和观察组(n=42)。对照组泵注丙泊酚+瑞芬太尼,观察组泵注苯磺酸瑞马唑仑+瑞芬太尼,比较两组不同时间[入室时(T_(1))、插管即刻(T_(2))、手术开始30min(T_(3))、拔管后5min(T_(4))]心率(HR)、平均动脉压(MAP)、认知功能、苏醒质量(苏醒时间、拔管时间及镇静评分)、不良反应。结果:观察组T_(3)、T_(4)时HR、MAP高于对照组(P<0.05);术后24h、48h Mo-CA评分观察组高于对照组(P<0.05);观察组苏醒、拔管时间短于对照组,Ramsay镇静评分高于对照组(P<0.05);观察组低血压、术后谵妄发生率低于对照组(P<0.05),而两组呼吸抑制、恶心呕吐比较,差异无统计学意义(P>0.05)。结论:老年脊柱骨折术中持续泵注苯磺酸瑞马唑仑维持麻醉能提高患者麻醉效果、认知功能、苏醒质量,减少术后谵妄发生风险。Objective:To study the effect of continuous infusion of remifentanil on postoperative delirium in elderly patients with spinal fracture.Methods:A total of 82 elderly patients with spinal fractures admitted to our hospital from May 2023 to May 2024 were selected and divided into control group(n=40)and observation group(n=42)according to intraoperative maintenance anesthesia.The control group was pumped with propofol+remifentanil,and the observation group was pumped with remazolam+remifentanil.The heart rate(HR),mean arterial pressure(MAP)at different times[entering the room(T_1),immediately after intubation(T_2),30 min after operation(T_3),5 min after extubation(T_4)],cognitive function,recovery quality(recovery time,extubation time and sedation score)and adverse reactions were compared between the two groups.Results:HR and MAP at T_3 and T_4 in the observation group were higher than those in the control group(P<0.05).The Mo-CA score of the observation group was higher than that of the control group at 24 h and 48 h after operation(P<0.05).The recovery time and extubation time of the observation group were shorter than those of the control group,and the Ramsay sedation score was higher than that of the control group(P<0.05).The incidence of hypotension and postoperative delirium in the observation group was lower than that in the control group(P<0.05),but there was no significant difference in respiratory depression,nausea and vomiting between the two groups(P>0.05).Conclusion:Continuous pumping of remazolam besylate to maintain anesthesia during spinal fracture surgery in the elderly can improve the anesthetic effect,cognitive function and recovery quality of patients,and reduce the risk of postoperative delirium.

关 键 词：脊柱骨折 丙泊酚 苯磺酸瑞马唑仑 谵妄 

分 类 号：R47[医药卫生—护理学]