甲苯磺酸瑞马唑仑对老年全身麻醉诱导期血流动力学的影响OACSTPCD
Effect of remimazolam tosylate on hemodynamics during the induction of general anesthesia in the elderly
目的 探讨甲苯磺酸瑞马唑仑对老年患者全身麻醉诱导期血流动力学的影响.方法 选择于我院行气管插管全身麻醉的非心脏手术老年患者90例,随机均分为甲苯磺酸瑞马唑仑组(R组)和依托咪酯组(E组).麻醉诱导时,给予R组患者甲苯磺酸瑞马唑仑0.3 mg/kg,给予E组患者依托咪酯0.3 mg/kg.比较2组患者麻醉诱导前(T0)、诱导完成即刻(T1)、气管插管后(T2)的心率(HR)、平均动脉压(MAP)、脑电双频指数(BIS).统计2组患者诱导时间、拔管时间、拔管后5 min时的Ramsay镇静评分、出麻醉后恢复室(PACU)时间、手术时间、麻醉时间及不良反应发生率.结果 2组患者T0时MAP、HR、BIS比较,差异均无统计学意义(P>0.05);R组患者T1、T2时MAP高于E组患者(P<0.05),T2时HR低于E组患者(P<0.05);与T0时比较,R组患者T1、T2时的HR、MAP和BIS均降低,E组患者T1、T2时MAP和BIS均降低,T1时HR下降,T2时HR升高,差异均有统计学意义(P<0.05).R组患者诱导时间及拔管时间短于E组患者(P<0.05).2组患者Ramsay镇静评分、出PACU时间、手术时间、麻醉时间比较,差异均无统计学意义(P>0.05).E组肌阵挛和低血压的发生率高于R组,不良反应总发生率高于R组,差异均有统计学意义(P<0.05).结论 相较于依托咪酯,甲苯磺酸瑞马唑仑用于老年患者全身麻醉诱导血流动力学更稳定,不良反应更少.
Objective To investigate the effect of rimimazolam tosylate on hemodynamics during the induction of general anesthesia in elderly patients.Methods A total of 90 elderly patients who received non-cardiac surgery under tracheal intubation general anesthesia in our hospital were selected,and randomly divided into the remimazolam tosylate group(group R)and the etomidate group(group E).During anesthesia induction,patients in the group R were given 0.3 mg/kg of remimazolam tosylate,and patients in the group E were given 0.3 mg/kg of etomidate.The heart rate(HR),mean arterial pressure(MAP),and bispectral index(BIS)before the induction of anesthesia(T0),after the induction of anesthesia(T1),and after tracheal intubation(T2)of patients in the two groups were compared.The induction time,extubation time,Ramsay sedation score 5 minutes after extubation,time out of the postanesthesia care unit(PACU),operation time,anesthesia time and incidence of adverse reactions in the two groups were counted.Results There was no significant difference in the MAP,HR or BIS of patients at T0 between the two groups(P>0.05);the MAP of patients at T1 and T2 in the group R were higher than those in the group E(P<0.05),and the HR of patients at T2 was lower than that in the group E(P<0.05).Compared with T0,the HR,MAP and BIS of patients at T1 and T2 in the group R were decreased;the MAP and BIS of patients at T1 and T2 in the group E were decreased,HR of patients was decreased at T1 and increased at T2,with statistically significant differences(P<0.05).The induction time and extubation time of patients in the group R were shorter than those in the group E(P<0.05).There was no significant difference in the Ramsay sedation score,time out of the PACU,operation time oranesthesia time of patients between the two groups(P>0.05).The incidences of myoclonus and hypotension of patients in the group E were higher than those in the group R,and the total incidence of adverse reactions in the group E was higher than that in the group R,with statistically significant differences(P<0.05).Conclusion Compared to etomidate,remazolam tosylate is more stable in inducing hemodynamics and has fewer adverse reactions in elderly patients under general anesthesia.
杜晨;田刚
十堰市人民医院/湖北医药学院附属人民医院麻醉手术中心,湖北 十堰 442000
临床医学
甲苯磺酸瑞马唑仑依托咪酯老年患者麻醉诱导血流动力学
rimimazolam tosylateetomidateelderly patientsanesthesia inductionhemodynamics
《局解手术学杂志》 2024 (002)
140-144 / 5
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