瑞马唑仑对重度烧伤患者苏醒期躁动及创伤后应激反应的影响  

Effect of remazolam on emergence agitation and post-traumatic stress responses in severely burned patients

作　　者：张金良 苗杨[2] ZHANG Jinliang;MIAO Yang(Department of Anesthesiology,the First People′s Hospital of Zhengzhou,Zhengzhou 450000,Henan Province,China;Department of Anesthesiology,Women and Infants Hospital of Zhengzhou,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州市第一人民医院麻醉科,河南郑州450000 [2]郑州市妇幼保健院麻醉科,河南郑州450000

出　　处：《新乡医学院学报》2025年第5期401-405,共5页Journal of Xinxiang Medical University

摘　　要：目的 探讨瑞马唑仑对重度烧伤患者苏醒期躁动及创伤后应激反应的影响。方法 选择2022年1月至2023年12月郑州市第一人民医院收治的重度烧伤患者86例为研究对象。根据使用的麻醉药物将患者分为对照组(n=40)和观察组(n=46)。对照组患者术中使用丙泊酚和瑞芬太尼维持麻醉,观察组患者使用瑞马唑仑和瑞芬太尼维持麻醉。比较2组患者术后自主呼吸恢复时间、苏醒时间、拔管时间和定向力恢复时间等术后恢复情况;比较2组患者苏醒期躁动发生率;于麻醉诱导前和拔管后15 min采集患者静脉血,采用色谱电化学法检测血浆中肾上腺素(E)和皮质醇(COR)水平,采用化学发光法和硫代巴比妥酸法检测血清中超氧化物歧化酶(SOD)和丙二醛(MDA)水平;记录2组患者不良反应发生情况。结果 观察组患者术后自主呼吸恢复时间、苏醒时间及定向力恢复时间均短于对照组(P<0.05);2组患者拔管时间比较差异无统计学意义(P>0.05)。观察组患者苏醒期躁动发生率显著低于对照组(P<0.05)。麻醉诱导前2组患者的血浆E、COR及血清SOD、MDA水平比较差异均无统计学意义(P>0.05)。与麻醉诱导前比较,2组患者拔管后15 min血浆E、COR及血清SOD水平显著升高,血清MDA水平显著降低(P<0.05)。拔管后15 min,观察组患者血浆E、COR水平及血清MDA水平显著低于对照组,血清SOD水平显著高于对照组(P<0.05)。对照组和观察组患者总不良反应发生率分别为35.00%(14/40)、10.87%(5/46),观察组患者总不良反应发生率显著低于对照组(χ^(2)=7.238,P<0.05)。结论 相较于丙泊酚,使用瑞马唑仑维持麻醉对深度烧伤患者呼吸系统的影响更小,可降低苏醒期躁动发生率,缓解术后应激反应,且安全性高。Objective To investigate the influence of remazolam on emergence agitation and post-traumatic stress responses in severely burned patients.Methods A total of 86 severely burned patients who admitted to the First People′s Hospital of Zhengzhou from January 2022 to December 2023 were included and divided into a control group(n=40)and an observation group(n=46)according to the anesthetic drug used.Patients in the control group were anesthetized with propofol and remifentanil while those in the observation group were anesthetized with remazolam and remifentanil during surgery.The postoperative spontaneous breathing recovery time,awakening time,extubation time,directional force recovery time and incidence of emergence agitation were compared between the two groups.Venous blood samples were collected from patients before anesthesia induction and 15 minutes after extubation.The plasma levels of adrenaline(E)and cortisol(COR)were detected using the chromatographic electrochemical method,while the serum levels of superoxide dismutase(SOD)and malondialdehyde(MDA)were measured using chemiluminescence and thiobarbituric acid methods.The adverse reactions in two groups of patients were recorded.Results The postoperative spontaneous breathing recovery time,awakening time and directional force recovery time in the observation group were all shorter than those in the control group(P<0.05).There was no significant difference in extubation time between the two groups(P>0.05).The incidence of emergence agitation in the observation group was significantly lower than that in the control group(P<0.05).There was no statistically significant difference in levels of plasma E,plasma COR,serum SOD and serum MDA between the two groups of patients before anesthesia induction(P>0.05).Compared with those before anesthesia induction,the levels of plasma E,plasma COR,and serum SOD significantly increased while serum MDA levels significantly decreased 15 minutes after extubation in both groups of patients(P<0.05).The observation group had signi

关 键 词：重度烧伤 瑞马唑仑 苏醒期躁动 创伤后应激反应 

分 类 号：R644[医药卫生—外科学]