REN Zhi-qiang 1LI Xiao-lei 1FAN Xue-jiao 1ZHOU Zhi-wen1
作者信息
- 1. Department of Critical Care Medicine,Shangqiu Municipal Hospital,Shangqiu 476000,China
- 折叠
摘要
Abstract
Objective:To investigate the effect of remimazolam on peripheral blood Tau levels and the risk of delirium in elderly patients with fractures.Methods:A total of 98 elderly patients with fractures admitted to a hospital from December 2022 to April 2025 were prospectively selected and assigned to the control group and the observation group using random number table method,with 49 patients in each group.During the induction of anesthesia,both groups received intravenous sufentanil citrate injection.Following this,the control group received propofol injectable emulsion,while the observation group received remimazolam tosilate for injection.During the maintenance of intraoperative anesthesia,both groups received propofol injectable emulsion combined with sufentanil citrate injection to maintain baseline anesthetic state,and rocuronium bromide injection was intermittently administered to maintain adequate muscle relaxation.The bispectral index(BIS)and stress level[heart rate(HR),mean arterial pressure(MAP)]at pre-induction(T0),1 min pre-intubation(T1),immediately after intubation(T2),1 min post-intubation(T3)and 5 min post-intubation(T4)were compared between the two groups.Moreover,peripheral blood Tau levels at 1 day pre-surgery,1 day post-surgery and 3 days post-surgery,and the risk of delirium within 3 days post-surgery,as well as adverse reactions were compared between the two groups.Meanwhile,a mediation effect model was constructed to analyze the mediating role of peripheral blood Tau levels between the anesthetic agents and the risk of postoperative delirium.Results:No statistically significant differences in BIS were observed between the two groups at different time points(P>0.05).Compared with the control group,the observation group showed higher MAP and lower HR at T1～T4(P<0.05).Peripheral blood Tau levels at 1 day post-surgery and 3 days post-surgery in the observation group were lower than those in the control group(P<0.05).The incidence of delirium within 3 days post-surgery in the observation group(10.20%)was lower than that in the control group(26.53%,χ2=4.356,P=0.037).No statistically significant difference in the total incidence of adverse reactions was observed between the two groups(P>0.05).The results of mediation effect analysis showed that peripheral blood Tau levels acted as a mediator,with the indirect effect accounting for 68.23%of the total effect.Conclusion:Remimazolam can effectively decrease postoperative peripheral blood Tau levels and reduce the risk of postoperative delirium in elderly patients with fractures.Furthermore,peripheral blood Tau levels play a significant mediating role between the anesthetic agents and the risk of postoperative delirium.关键词
瑞马唑仑/老年骨折/外周血Tau水平/谵妄/应激水平Key words
remimazolam/elderly fractures/peripheral blood Tau levels/delirium/stress levels分类
医药卫生
