瑞马唑仑对髋关节置换术后老年患者熵指数及镇静评分的影响  

Influence of remimazolam on entropy index and sedation score in elderly patients after hip replacement

作　　者：樊超 张明敏 曹施萍 项杰 段君锋 FAN Chao;ZHANG Mingmin;CAO Shiping;XIANG Jie;DUAN Junfeng(Department of Anesthesiology,Hangzhou Fuyang Hospital of Orthopedics of Traditional Chinese Medicine,Hangzhou 311400,China;Department of Joint,Hangzhou Fuyang Hospital of Orthopedics of Traditional Chinese Medicine,Hangzhou 311400,China)

机构地区：[1]杭州市富阳中医骨伤医院麻醉科,杭州311400 [2]杭州市富阳中医骨伤医院关节科,杭州311400

出　　处：《药学前沿》2025年第3期458-465,共8页China Pharmacist

基　　金：浙江省中医药科技计划项目(2024ZL820)。

摘　　要：目的探讨瑞马唑仑对髋关节置换术后老年患者熵指数及镇静评分的影响。方法回顾分析2021年6月至2024年6月期间在杭州市富阳中医骨伤医院接受髋关节置换术患者的临床资料,根据术中瑞马唑仑使用剂量不同分为低剂量组和高剂量组。比较两组患者各时间点的脑功能熵指数的反应熵(RE)、状态熵(SE)和脑电双频指数(BIS)、Ramsay镇静评分、各时间点的认知功能[蒙特利尔认知评估量表(MoCA)、简易精神状态检查量表(MMSE)]评分、围手术期麻醉相关指标及术后不良反应发生情况。结果共纳入100例患者,其中高剂量组52例,低剂量组48例。两组患者术中各时间点的RE、SE及BIS值均较术前下降(P<0.05),Ramsay评分均高于术前(P<0.05),但组间差异无统计学意义(P>0.05)。与高剂量组相比,低剂量组术中平均动脉压(MAP)及心率(HR)波动较小,术后低剂量组MoCA、MMSE评分更高,恢复室停留、苏醒时间更短,总不良反应发生率更低(P<0.05)。结论低剂量瑞马唑仑可为老年髋关节置换术患者提供良好的镇静效果,维持血流动力学稳定,减少术后认知功能障碍的发生,缩短恢复时间,且安全性更优。Objective To investigate the effect of remimazolam on entropy index and sedation score in elderly patients after hip replacement.Methods The clinical data of patients who underwent hip replacement in Hangzhou Fuyang Hospital of Orthopedics of Traditional Chinese Medicine from June 2021 to June 2024 were retrospectively analyzed and divided into the low-dose group and the high-dose group according to the different doses of remimazolam used during the operation.The response entropy(RE),state entropy(SE)and bispectral index(BIS)of brain function entropy index at each time point,Ramsay sedation score,cognitive function(MoCA and MMSE)score at each time point,perioperative anesthesia-related indicators and postoperative adverse reactions were compared between the two groups.Results A total of 100 patients were included,with 52 in the high-dose group and 48 in the low-dose group.The RE,SE and BIS values of the two groups at each time point during the operation were decreased compared with those before the operation(P<0.05),and the Ramsay scores were higher than those before the operation(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).Compared with the high-dose group,the intraoperative MAP and HR fluctuations in the low-dose group were smaller,the MoCA and MMSE scores in the low-dose group were higher after surgery(P<0.05),the recovery room stay and awakening time in the low-dose group were shorter(P<0.05),and the total incidence of adverse reactions in the low-dose group was lower(P<0.05).Conclusion Low-dose remimazolam can provide good sedation effect for elderly patients undergoing hip replacement,maintain hemodynamic stability,reduce the occurrence of postoperative cognitive dysfunction,shorten recovery time,and has better safety.

关 键 词：瑞马唑仑 熵指数 镇静评分 老年 髋关节置换术 认知功能 

分 类 号：R684[医药卫生—骨科学]