小剂量咪达唑仑复合丙泊酚用于老年无痛胃镜检查患者对麻醉效果及苏醒质量的影响  

Influences of low-dose midazolam combined with propofol on anesthesia effect and recovery quality in elderly patients undergoing painless gastroscopy

作　　者：赵艳艳 高宇恒 曹世鸣 Zhao Yan-yan;Gao Yu-heng;Cao Shi-ming(Department of Anesthesiology,Lianshi People’s Hospital,Nanxun District of Huzhou City,Huzhou 313000,China)

机构地区：[1]浙江省湖州市南浔区练市人民医院麻醉科,湖州313000

出　　处：《中国药物应用与监测》2025年第1期106-110,共5页Chinese Journal of Drug Application and Monitoring

摘　　要：目的探讨小剂量咪达唑仑复合丙泊酚用于老年无痛胃镜检查患者对麻醉效果及苏醒质量的影响。方法回顾性分析2022年6月至2023年8月在湖州市南浔区练市人民医院行无痛胃镜检查的120例老年患者的病历资料,按照麻醉方法的不同分为咪达唑仑复合丙泊酚组(n=60)和丙泊酚组(n=60)。丙泊酚组采用丙泊酚进行麻醉,咪达唑仑复合丙泊酚组采用小剂量咪达唑仑复合丙泊酚麻醉。比较两组麻醉效果(丙泊酚用量、苏醒时间、定向力恢复时间);麻醉前(T_(0))、麻醉后5 min(T_(1))、唤醒时(T_(2))时血流动力学[心率(HR)、平均动脉压(MAP)];T_(0)、术后1 h(T_(3))时的苏醒质量[采用40项恢复质量评分量表(QOR-40)评估];T_(0)、T_(3)、术后2 h(T_(4))、术后3 h(T_(5))时的认知功能[采用简易精神状态评价量表(MMSE)评估];T_(0)、T_(3)时脑缺血情况[脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)、达峰时间(TTP)]和不良反应发生情况。结果咪达唑仑复合丙泊酚组丙泊酚用量为(93.70±20.42)mg,低于丙泊酚组的(128.36±31.98)mg,差异有统计学意义(t=7.076,P<0.05)。咪达唑仑复合丙泊酚组苏醒时间、定向力恢复时间[分别是(9.12±1.68)min、(15.65±3.16)min],短于丙泊酚组[分别是(11.03±2.09)min、(18.33±3.37)min],差异有统计学意义(t=5.517、4.494,均P<0.05);T_(1)、T_(2)时,咪达唑仑复合丙泊酚组HR、MAP为[(76.53±4.26)次·min^(-1)、(80.07±4.90)次·min^(-1)和(72.78±4.25)mm Hg(1 mm Hg≈0.133 kPa)、(78.95±5.13)mm Hg],低于丙泊酚组[(78.81±3.72)次·min^(-1)、(82.44±4.88)次·min^(-1)和(76.67±4.56)mm Hg、(82.02±5.77)mm Hg],差异有统计学意义(t=3.123、2.665、4.834、3.080,均P<0.05);T_(3)时,咪达唑仑复合丙泊酚组身体舒适度、疼痛、情绪状态评分及总分[(50.78±3.56)分、(28.87±3.06)分、(37.82±3.69)分、(167.59±13.65)分],高于丙泊酚组[(48.32±3.80)分、(26.76±3.13)分、(36.17±3.33)分、(160.53±15.28)�Objective To explore the influences of low-dose midazolam combined with propofol on anesthesia effect and recovery quality in elderly patients undergoing painless gastroscopy.Methods A total of 120 elderly patients undergoing painless gastroscopy in Lianshi People’s Hospital from June 2022 to August 2023 were retrospectively selected as the research objects.According to the anesthesia method,they were divided into the combined group(n=60,midazolam combined with propofol)and propofol group(n=60).The patients in the propofol group were given propofol while those in the combined were given low-dose midazolam in combination with propofol for anesthesia.The anesthesia effect(dosage of propofol,awaking time,recovery time of orientation),hemodynamics(heart rate(HR),mean arterial pressure(MAP))before anesthesia(T_(0)),at 5 min after anesthesia(T_(1))and after awakening(T_(2)),recovery quality(40-item quality of recovery score(QOR-40))at T_(0) and 1 h after after surgery(T_(3)),cognitive function(mini-mental state examination(MMSE))at T_(0),T_(3),2 h after after surgery(T_(4)),3 h after after surgery(T_(5)),cerebral ischemia(cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),time to peak(TTP))at T_(0) and T_(3) and adverse reactions were compared between the two groups.Results The dosage of propofol in the combined group was(93.70±20.42)mg,lower than that of(128.36±31.98)mg in the propofol group,and the difference was statistically significant(t=7.076,P<0.05).The awaking time and recovery time of orientation in the combined group((9.12±1.68)min and(15.65±3.16)min,respectively)were shorter than those in the propofol group((11.03±2.09)min and(18.33±3.37)min,respectively),and the difference was statistically significant(t=5.517,4.494,both P<0.05).The HR and MAP at T_(1) and T_(2) in the the combined group((76.53±4.26)times·min^(-1),(80.07±4.90)times·min^(-1) and(72.78±4.25)mm Hg(1 mm Hg≈0.133 kPa),(78.95±5.13)mm Hg)were lower than those in the propofol group((78.81±3.72)times·min^(-1

关 键 词：麻醉方法 胃镜检查 咪达唑仑 丙泊酚 血流动力学 认知功能 安全性 

分 类 号：R614[医药卫生—麻醉学]