摘要
【目的】探讨瑞马唑仑复合全麻对老年腹腔镜手术患者认知功能、血流动力学的影响。【方法】82例行老年腹腔镜手术的患者,随机分为观察组和对照组,每组41例。对照组给予丙泊酚麻醉诱导,观察组给予瑞马唑仑麻醉诱导。比较两组诱导前后的心率(HR)、平均动脉压(MAP),比较两组术前及术后简易精神状态量表(MMSE)评分,比较两组麻醉情况和不良反应发生率。【结果】与诱导前比较,两组插管前即刻、插管后1 min和3 min时HR、MAP均显著降低(P<0.05),但观察组上述各时段的HR、MAP显著高于对照组(P<0.05)。两组MMSE评分术后24 h低于术前1 d(P<0.05),术后72 h显著高于术后24 h(P<0.05),观察组术后24 h、72 h MMSE评分低于对照组(P<0.05)。观察组麻醉起效时间长于对照组(P<0.05),苏醒时间短于对照组(P<0.05);两组麻醉后监测治疗室(PACU)滞留时间比较,差异无统计学意义(P>0.05)。观察组低血压、心动过缓、低氧血症、注射痛发生率低于对照组(P<0.05)。【结论】瑞马唑仑复合全麻能有效维持老年腹腔镜手术患者血流动力学平稳,改善认知功能,减少不良反应的发生,值得临床推广应用。
【Objective】To explore the effects of remimazolam combined with general anesthesia on hemodynamics and cognitive function in elderly patients undergoing laparoscopic surgery.【Methods】A total of 82 elderly patients undergoing laparoscopic surgery were randomly divided into the observation group and the control group,with 41 patients in each group.The control group received propofol for anesthesia induction,while the observation group received remimazolam.Heart rate(HR)and mean arterial pressure(MAP)changes before and after induction were compared between the two groups.Additionally,the Mini-Mental State Examination(MMSE)scores before and after surgery,anesthesia conditions,and the incidence of adverse reactions in both groups were compared as well.【Results】Compared to pre-induction,both groups showed a significant decrease in HR and MAP immediately before intubation and at 1 minute and 3 minutes after intubation(P<0.05).The HR and MAP values at these time points in the observation group were significantly higher than those in the control group(P<0.05).The MMSE scores in both groups significantly decreased from 1 day before surgery to 24 hours after surgery(P<0.05),then significantly increased from 24 hours to 72 hours postoperatively(P<0.05).The MMSE scores in the observation group at 24 hours and 72 hours postoperatively were lower than those in the control group at 24 hours and 72 hours postoperatively(P<0.05),respectively.The time to achieve anesthesia in the observation group was longer than that in the control group(P<0.05),while the recovery time was shorter than that in the control group(P<0.05).There was no statistically significant difference in the length of stay in the post-anesthesia care unit(PACU)between the two groups(P>0.05).The incidence of hypotension,bradycardia,hypoxemia,and injection pain in the observation group was lower than that in the control group(P<0.05).【Conclusion】Remimazolam combined with general anesthesia can effectively maintain stable hemodynamics,improve cognitive function,and reduce the incidence of adverse reactions in elderly patients undergoing laparoscopic surgery.It is worthy of clinical promotion and application.
作者
姚莺
李倩楠
YAO Ying;LI Qiannan(Department of Anesthesiology,Kangjiang Hospital,Yangpu District,Shanghai 200093)
出处
《医学临床研究》
CAS
2024年第10期1543-1546,共4页
Journal of Clinical Research
