右江医学2025，Vol.53Issue(6)：506-515,10.DOI:10.3969/j.issn.1003-1383.2025.06.005
甲苯磺酸瑞马唑仑对经皮肾镜取石术老年患者血流动力学及肾功能的影响
Effect of remimazolam tosilate on hemodynamics and renal function in elderly patients undergoing percutaneous nephrolithotomy
摘要
Abstract
Objective To investigate the effects of remimazolam tosilate on perioperative hemodynamics and renal func-tion in elderly patients undergoing percutaneous nephrolithotomy(PCNL).Methods A total of 60 elderly patients sched-uled for elective PCNL under general anesthesia at the First Affiliated Hospital of Guangxi Medical University from January to December 2022 were selected.They were randomly divided into remimazolam tosilate group(group R,n=30)and propofol group(group D,n=30)according to random number table.Anesthesia induction protocol:in the group R,remimazolam tosilate was administered intravenously at a dose of 0.2 mg/kg.In the group D,propofol was administered at a dose of 2.0 mg/kg.The remaining treatments were the same for both groups:target-controlled infusion(TCI)of remifentanil at a target concentration of 3.0 ng/mL,followed by an establishment of an artificial airway after the administration of cisatracurium of 0.25 mg/kg.The group R was continuously pumped with remazolam tosylate of 0.1 mg/(kg·h),and the group D was continuously pumped with normal saline of the same volume of remazolam tosylate.Serum renal function related indicators,including serum creatinine(Scr),blood urea nitrogen(BUN),retinol binding protein(RBP)and cystatin C(CYS-C)concentrations,were recorded 24 hours before surgery(d0),24 hours after surgery(d1)and 72 hours after surgery(d2).Heart rate(HR)and mean arterial pressure(MAP)were recorded at four different time points:before induction(T0),immediately after intubation(T1),5 min after intubation(T2)and 15 min after intubation(T3).In addition,the occur-rence of intraoperative adverse cardiovascular events(bradycardia or tachycardia,hypertension,and hypotension)was recor-ded.Results There were no statistically significant differences in the renal function related indicators(BUN,Scr,CYS-C,RBP)between the two groups at each time point(P>0.05).For HR and MAP,there were no statistically significant differ-ences between the group R and the group D at T0 and T3(P>0.05).However,at T1 and T2,the HR and MAP in the group R were significantly higher than those in the group D(P<0.05).With T0 as the baseline value,within-group comparisons showed that the HR and MAP in both groups significantly decreased at T1 and T2(P<0.05).The incidence of intraoperative adverse events(hypotension,bradycardia,and injection pain)and the proportion of vasopressor rescue drugs(ephedrine)in the group R were significantly lower than those in the group D(P<0.05).Conclusion Remimazolam tosilate can reduce the incidence of perioperative hypotension and bradycardia in elderly patients undergoing PCNL,and it has no significant impact on their renal functions.关键词
全身麻醉/甲苯磺酸瑞马唑仑/经皮肾镜取石术/老年患者/血流动力学/肾功能Key words
general anesthesia/remimazolam tosilate/percutaneous nephrolithotomy(PCNL)/elderly patients/hemody-namics/renal function分类
医药卫生引用本文复制引用
覃艳坤,马小英,邓仪,莫小倩,曾涟..甲苯磺酸瑞马唑仑对经皮肾镜取石术老年患者血流动力学及肾功能的影响[J].右江医学,2025,53(6):506-515,10.基金项目
广西医疗卫生适宜技术开发与推广应用项目(S2020027) （S2020027）
