不同剂量瑞马唑仑全身麻醉诱导对结肠癌根治术病人气管插管应激反应及血流动力学的影响  

Influence of general anesthesia induction with different doses of remimazolam on tracheal intubation stress response and hemodynamics in patients with radical resection of colon cancer

作　　者：李淑萍 王璐 胡淑娜 LI Shuping;WANG Lu;HU Shuna(Department of Anesthesiology,Xi’an Gaoxin Hospital,Xi’an 710000,Shaanxi,China;不详)

机构地区：[1]西安高新医院麻醉科,710000 [2]西安医学院第二附属医院麻醉科 [3]新疆托克逊县人民医院手术麻醉科

出　　处：《临床外科杂志》2025年第3期306-309,共4页Journal of Clinical Surgery

摘　　要：目的观察不同剂量瑞马唑仑全麻诱导对结肠癌根治术病人气管插管应激反应及血流动力学的影响。方法2020年8月~2023年8月实施结肠癌根治术的病人75例,均采用瑞马唑仑行全身麻醉诱导。采用随机数字表法分为三组:A组25例,瑞马唑仑剂量为0.2 mg/kg;B组25例,瑞马唑仑剂量为0.3 mg/kg;C组25例,马唑仑剂量为0.4 mg/kg。比较三组病人麻醉给药前(T0)、气管插管时(T1)、插管后30分钟(T2)、拔管后10分钟(T3)应激反应情况[皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)]、血流动力学[心率(HR)、平均动脉压(MAP)]变化情况。比较三组病人麻醉恢复情况。比较三组病人麻醉不良反应总发生率。结果T0时,三组病人Cor、E、NE、HR、SVI、MAP水平比较,差异无统计学意义(P>0.05)。T1~T3时,A组Cor、E、NE水平[T1:(181.76±12.49)pg/ml、(67.94±2.66)ng/ml、(355.12±19.82)ng/ml;T2:(231.90±15.82)pg/ml、(72.15±2.83)ng/ml、(379.86±20.31)ng/ml;T3:(300.65±17.43)pg/ml、(77.82±2.85)ng/ml、(405.31±24.36)ng/ml]均高于B组[T1:(172.31±12.07)pg/ml、(66.22±2.73)ng/ml、(326.47±19.24)ng/ml;T2:(214.75±14.88)pg/ml、(70.34±2.79)ng/ml、(354.18±20.66)ng/ml;T3:(279.08±16.62)pg/ml、(75.03±2.81)ng/ml、(387.05±22.82)ng/ml]、C组[T1:(165.44±11.74)pg/ml、(64.01±2.75)ng/ml、(300.66±19.50)ng/ml;T2:(200.42±14.35)pg/ml、(67.59±2.80)ng/ml、(330.18±21.05)ng/ml;T3:(251.33±16.08)pg/ml、(72.44±2.70)ng/ml、(354.11±22.07)ng/ml],两组比较差异有统计学意义(P<0.05);T1~T2时,A组的HR、MAP[T1:(79.49±4.05)次/分、(96.09±1.77)mmHg;T2:(76.55±3.83)次/分、(94.88±1.55)mmHg]高于B组[T1:(76.22±3.89)次/分、(95.01±1.63)mmHg;T2:(74.23±3.76)次/分、(93.89±1.51)mmHg]、C组的[T1:(73.65±3.81)次/分、(94.02±1.61)mmHg;T2:(71.55±3.61)次/分、(92.97±1.46)mmHg],两组比较差异有统计学意义(P<0.05);T3时三组病人HR、MAP比较差异无统计学意义(P>0.05)。C组病人呼吸恢复、睁眼、拔管时间均显著长于A组、BObjective To explore the influence of different doses of remimazolam for general anesthesia induction on tracheal intubation stress response and hemodynamics in patients undergoing radical resection of colon cancer.Methods From August 2020 to August 2023,75 patients undergoing radical resection of colon cancer were induced by general anesthesia using remazolam.According to the random number table method,they were divided into group A(25 cases,0.2 mg/kg of remimazolam),group B(25 cases,0.3 mg/kg of remimazolam)and group C(25 cases,0.4 mg/kg of remimazolam).The stress response status[cortisol(Cor),epinephrine(E),norepinephrine(NE)]and hemodynamics[heart rate(HR),mean arterial pressure(MAP)]before anesthesia(T0),at tracheal intubation(T1),at 30 min after intubation(T2)and at 10 min after extubation(T3),anesthesia recovery status and total incidence rate of adverse anesthesia reactions were compared among the three groups.Results At T0,there were no obvious differences in the levels of Cor,E,NE,HR,SVI and MAP among the three groups(P>0.05).At T1-T3,the levels of Cor,E and NE in group A[T1:(181.76±12.49)pg/ml,(67.94±2.66)ng/ml,(355.12±19.82)ng/ml;(231.90±15.82)pg/ml,(72.15±2.83)ng/ml,(379.86±20.31)ng/ml;T3:(300.65±17.43)pg/ml,(77.82±2.85)ng/ml,(405.31±24.36)ng/ml]were higher than those in group B[T1:(172.31±12.07)pg/ml,(66.22±2.73)ng/ml,(326.47±19.24)ng/ml;T2:(214.75±14.88)pg/ml,(70.34±2.79)ng/ml,(354.18±20.66)ng/ml;T3:(279.08±16.62)pg/ml,(75.03±2.81)ng/ml,(387.05±22.82)ng/ml]and group C[T1:(165.44±11.74)pg/ml,(64.01±2.75)ng/ml,(300.66±19.50)ng/ml;T2:(200.42±14.35)pg/ml,(67.59±2.80)ng/ml,(330.18±21.05)ng/ml;T3:(251.33±16.08)pg/ml,(72.44±2.70)ng/ml,(354.11±22.07)ng/ml](P<0.05).At T1-T2,the HR and MAP were higher in group A[T1:(79.49±4.05)beats/min,(96.09±1.77)mmHg;T2:(76.55±3.83)beats/min,(94.88±1.55)mmHg]than those in group B[T1:(76.22±3.89)beats/min,(95.01±1.63)mmHg;T2:(74.23±3.76)beats/min,(93.89±1.51)mmHg]and group C[T1:(73.65±3.81)beats/min,(94.02±1.61)mmHg;T2:(71.55±3.61)beat

关 键 词：瑞马唑仑 全麻诱导 结肠癌根治术 应激反应 血流动力学 

分 类 号：R61[医药卫生—外科学]