川北医学院学报2023，Vol.38Issue(12)：1680-1684,5.DOI:10.3969/j.issn.1005-3697.2023.12.022
脑氧饱和度监测联合瑞马唑仑麻醉对老年关节置换术患者术后谵妄及血清水平的影响
Effect of monitoring cerebral regional oxygen saturation combined with remidazolam anesthesia on postoperative delirium and serum S100β levels in elderly patients undergoing joint replacement surgery
摘要
Abstract
Objective:To explore the effect of monitoring cerebral regional oxygen saturation(rSO2)combined with remidazolam anesthesia on postoperative delirium and serum central nervous system specific protein(S100β)in elderly patients undergoing joint re-placement surgery.Methods:112 elderly patients who underwent joint replacement surgery were selected as the study subjects.They were divided into control group and observation group according to differennt treatment methods,with 56 cases in each group.The con-trol group received conventional remimazolam anesthesia regimen,and the observation group used rSO2 +remimazolam anesthesia regi-men,and the anesthesia induction and maintenance stages were the same in both groups.The incidence of postoperative delirium(POD)[Delirium Scoring Method Chinese Revised Version(CAM-CR)],changes in vital signs levels[changes in mean arterial pres-sure(MAP),heart rate(HR),and BIS]at different time points[preoperative(T0),5 minutes after anesthesia(T1),3 minutes after surgery(T2),30 minutes after surgery(T3),and immediately after surgery(T4)],changes of S100β in different time points[preop-erative,immediate postoperative,postoperative 24 hours,and postoperative 48 hours],and comparison of intraoperative and postoperative conditions between the two groups[dosage of ramazolam,postoperative eye opening time,and post anesthesia monitoring treatment room(PACU)stay time]were compared between two groups,and the occurrence of remedial sedation and adverse reactions in both groups were recorded.Results:The incidence of POD in the observation group was lower than that in the control group at 7 days after opera-tion,the occurrence time of POD in the observation group was later than that in the control group,and the duration was shorter than that in the control group(P<0.05).Compared to T0,the MPA,HR,and BIS of both T1～T4 groups decreased(P<0.05).Compared with the control group,the observation group had higher MAP and lower BIS at T1～T4(P<0.05),there was no significant difference in HR between the two groups of TI～T4(P>0.05).The protein levels of serum S100β in two groups immediately after surgery,and 24 and 48 hours after surgery were all higher than before surgery(P<0.05),and over time,The protein levels of serum S100β was de-creased after surgery,and the observed group was lower than the control group(P<0.05).The dosage of Rimazolam in the observation group was lower than that in the control group(P<0.05),the observation group had shorter eye opening time and PACU retention time than the control group(P<0.05).There was no significant difference in the incidence of rescue sedation and adverse reactions be-tween the two groups(P>0.05).Conclusion:rSO2 monitoring combined with remidazolam anesthesia can reduce the incidence of POD and serum S100β protein levels in elderly patients undergoing joint replacement surgery,effectively maintain stable vital signs,and without increasing the incidence of adverse reactions.关键词
脑氧饱和度/瑞马唑仑/老年/关节置换/术后谵妄/中枢神经特异蛋白Key words
Cerebral regional oxygen saturation/Remazolam/Old age/Joint replacement/Postoperative delirium/Central nervous system specific protein分类
医药卫生引用本文复制引用
赵建华,李双江,李梅,刘秀坤,张璐..脑氧饱和度监测联合瑞马唑仑麻醉对老年关节置换术患者术后谵妄及血清水平的影响[J].川北医学院学报,2023,38(12):1680-1684,5.基金项目
河北省秦皇岛市科学技术研究与发展计划项目(202101A118) （202101A118）
