摘要
目的评价瑞马唑仑复合瑞芬太尼麻醉用于衰弱老年患者胃癌根治术的效果。方法择期行腹腔镜胃癌根治术患者120例,年龄65~75岁,性别不限,BMI 18~28 kg/m^(2),简易虚弱问卷量表评分3~5分,按照随机数字表法分为3组(n=40):丙泊酚复合瑞芬太尼组(P组)、低剂量瑞马唑仑复合瑞芬太尼组(B1组)和高剂量瑞马唑仑复合瑞芬太尼组(B2组)。麻醉诱导:P组静脉注射丙泊酚2 mg/kg,B1组和B2组分别静脉泵注瑞马唑仑6和12 mg·kg^(-1)·h^(-1),意识消失后3组静脉注射阿芬太尼和罗库溴铵。麻醉维持:P组静脉泵注丙泊酚4~12 mg·kg^(-1)·h^(-1),B1组和B2组静脉泵注瑞马唑仑0.5~1.0 mg·kg^(-1)·h^(-1),3组静脉输注瑞芬太尼0.05~0.20μg·kg^(-1)·h^(-1),间断静脉注射罗库溴铵,术中维持BIS值45~55。记录意识消失时间、意识恢复时间和气管拔管时间;记录麻醉诱导时注射痛、术中心血管事件、术中知晓和PACU期间呼吸抑制、恶心呕吐、嗜睡的发生情况。结果与P组比较,B1组和B2组意识消失时间延长,注射痛、术中低血压和心动过缓发生率降低,术后嗜睡发生率升高(P<0.05);与B1组比较,B2组意识消失时间缩短(P<0.05);3组意识恢复时间和气管拔管时间、术后呼吸抑制和恶心呕吐发生率比较差异无统计学意义(P>0.05)。结论瑞马唑仑复合瑞芬太尼麻醉可安全有效地用于衰弱老年患者胃癌根治术。
Objective To evaluate the efficacy of remazolam combined with remifentanil anesthesia for radical surgery for gastric cancer in frail aged patients.Methods One hundred and twenty patients of either sex,aged 65-75 yr,with body mass index 18-28 kg/m^(2),with simple frailty questionnaire score 3-5 points,undergoing elective laparoscopic radical gastric cancer surgery,were divided into 3 groups(n=40 each)according to the random number table method:propofol combined with remifentanil group(P group),low-dose remazolam combined with remifentanil group(B1 group)and high-dose remazolam combined with remifentanil group(B2 group).Induction of anesthesia was as follows:propofol 2 mg/kg was intravenously injected in group P,remazolam 6 and 12 mg·kg^(-1)·h^(-1) were intravenously infused in group B1 and group B2,respectively,and alfentanil and rocuronium were intravenously injected after loss of consciousness in three groups.Anesthesia maintenance was as follows:propofol 4^(-1)2 mg·kg^(-1)·h^(-1) was intravenously infused in group P,remazolam 0.5^(-1).0 mg·kg^(-1)·h^(-1) was intravenously infused in B1 and B2 groups,remifentanil 0.05-0.20μg·kg^(-1)·h^(-1) was intravenously infused in three groups,and intravenous rocuronium was injected intermittently to maintain the BIS value at 45-55 intraoperatively.The time to loss of consciousness,recovery time of consciousness and time of tracheal extubation were recorded.The occurrence of injection pain during induction of anesthesia,intraoperative cardiovascular events,intraoperative awareness,and respiratory depression,nausea and vomiting,and drowsiness during postanesthesia care unit were recorded.Results Compared with group P,the time to loss of consciousness was significantly prolonged,the incidence of injection pain,intraoperative hypotension and bradycardia was decreased,and the incidence of postoperative somnolence was increased in B1 and B2 groups(P<0.05).The time to loss of consciousness was significantly shorter in group B2 than in group B1(P<0.05).There was no statis
作者
李会新
邢飞
张卫
杨建军
袁静静
Li Huixin;Xing Fei;Zhang Wei;Yang Jianjun;Yuan Jingjing(Department of Anesthesiology and Perioperative Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2021年第11期1343-1346,共4页
Chinese Journal of Anesthesiology
基金
国家自然科学基金青年科学基金(82001187)。
