瑞马唑仑联合星状神经节阻滞对老年咽鼓管球囊扩张术患者术后认知功能的影响  

Effect of Remimazolam Combined with Stellate Ganglion Block on Postoperative Cognitive Function in Elderly Patients Undergoing Balloon Eustachian Tuboplasty

作　　者：夏靖宇 杨贝贝 夏晓琼[1] 李元海[1] XIA Jingyu;YANG Beibei;XIA Xiaoqiong;LI Yuanhai(Department of Anesthesiology,Chaohu Hospital of Anhui Medical University,Chaohu 238000,Anhui,China)

机构地区：[1]安徽医科大学附属巢湖医院麻醉科,安徽巢湖238000

出　　处：《医学信息》2025年第4期97-101,共5页Journal of Medical Information

基　　金：安徽医科大学麻醉学与药理学共建项目(编号:2021lcxk040)。

摘　　要：目的探讨应用瑞马唑仑联合星状神经节阻滞(SGB)对老年咽鼓管球囊扩张术患者术后认知功能的影响。方法选取2024年1月-6月入我院需接受咽鼓管球囊扩张成形术治疗的患者90例,按照随机数字表法分为瑞马唑仑组(R组,n=45)和瑞马唑仑联合SGB组(RS组,n=45)。R组以瑞马唑仑诱导并维持麻醉至手术结束,RS组先给予SGB,再以瑞马唑仑诱导并维持麻醉至手术结束。记录两组患者麻醉诱导前(T0)、气管插管时(T1),术毕(T2)、拔管时(T3)的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)以及局部脑氧饱和度(rScO2)等指标。术前1天和术后2 h检测血清S100β蛋白和白细胞介素(IL)-6水平,并于术前1天、术后2 h、术后1天和术后3天进行简易智力状况检查法(MMSE)评分,评估患者认知功能。结果RS组T0、T2的血流动力学指标与R组比较,差异无统计学意义(P>0.05),但T1、T3的血流动力学指标更为稳定(P<0.05)。两组患者T0的rScO2比较,差异无统计学意义(P>0.05),而RS组T1、T2、T3的rScO2高于R组(P<0.05)。术后2 h血清S100β蛋白和IL-6水平均升高,且R组高于RS组(P<0.05)。RS组术后2 h和术后1天的MMSE评分高于R组(P<0.05),两组术前1天和术后3天的MMSE评分比较,差异无统计学意义(P>0.05)。结论在老年患者咽鼓管球囊扩张术中应用瑞马唑仑联合星状神经节阻滞可进一步保持患者血流动力学稳定、降低机体炎症反应、增加脑氧饱和度,改善术后认知功能。Objective To investigate the effect of remimazolam combined with stellate ganglion block(SGB)on postoperative cognitive function in elderly patients undergoing balloon eustachian tuboplasty.Methods From January to June 2024,90 patients who were admitted to our hospital and underwent balloon eustachian tuboplasty were selected.According to the random number table method,they were divided into the remimazolam group(group R,n=45)and the remimazolam combined with SGB group(group RS,n=45).In group R,anesthesia was induced and maintained with remimazolam until the end of operation.In group RS,SGB was given first,and then anesthesia was induced and maintained with remimazolam until the end of operation.The mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2)and regional cerebral oxygen saturation(rScO2)were recorded before anesthesia induction(T0),tracheal intubation(T1),end of operation(T2)and extubation(T3).The levels of serum S100βprotein and interleukin(IL)-6 were detected at 1 day before operation and 2 hours after operation.The Mini-mental State Examination(MMSE)score was performed at 1 day before operation,2 hours after operation,1 day after operation and 3 days after operation to evaluate the cognitive function of patients.Results There was no significant difference in hemodynamic indexes at T0 and T2 between group RS and group R(P>0.05),but the hemodynamic indexes at T1 and T3 were more stable(P<0.05).There was no significant difference in rScO2 at T0 between the two groups(P>0.05),while the rScO2 at T1,T2 and T3 in the RS group was higher than that in the group R(P<0.05).The levels of serum S100βprotein and IL-6 increased at 2 h after operation,and the levels in group R were higher than those in group RS(P<0.05).The MMSE score of RS group at 2 hours and 1 day after operation was higher than that of group R(P<0.05).There was no significant difference in MMSE scores between the two groups at 1 day before operation and 3 days after operation(P>0.05).Conclusion For elderly patients undergoing

关 键 词：星状神经节阻滞 瑞马唑仑 老年 认知功能 血流动力学 炎症因子 脑氧饱和度 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]