摘要
目的观察瑞马唑仑用于全身麻醉诱导时对胸科手术患者双腔支气管导管气管插管应激反应的影响。方法选取2021年11月至2022年1月西部战区总医院拟在全身麻醉单肺通气下行胸科手术的62例患者为研究对象,采用随机数字表法分为对照组和试验组,每组31例。对照组采用丙泊酚2 mg/kg,试验组采用瑞马唑仑0.3 mg/kg,两组均联合舒芬太尼0.5μg/kg、顺式阿曲库铵0.2 mg/kg进行麻醉诱导,诱导完成后两组均置入可视双腔气管导管完成气管插管。记录入手术室后5 min(T0)、意识消失时(T1)、插管前即刻(T2)、插管后3 min(T3)及插管后10 min(T4)的平均动脉压(MAP)和心率;记录诱导期间低血压和心动过缓的发生情况。于T0、T2及T4抽取患者静脉血3 mL,采用ELISA检测血清促肾上腺皮质激素(ACTH)和去甲肾上腺素(NA)水平。结果与T0比较,对照组T1~T4 MAP明显降低,T1、T2及T4心率明显降低,差异有统计学意义(P<0.05)。与对照组比较,试验组T1~T4 MAP及心率明显升高,差异有统计学意义(P<0.05)。与T0比较,对照组T2、T4 ACTH和NA水平明显升高,差异有统计学意义(P<0.05)。与对照组比较,试验组T2、T4 ACTH和NA水平明显下降,差异有统计学意义(P<0.05)。两组低血压及心动过缓发生率比较,差异无统计学意义(P>0.05)。结论瑞马唑仑可减轻全身麻醉诱导时插管应激反应。
Objective To observe the effect of remazolam on stress response of double lumen bronchotube intubation in patients undergoing thoracic surgery during general anesthesia induction.Methods A total of 62 patients who were going to undergo thoracic surgery under general anesthesia with one-lung ventilation from November 2021 to January 2022 in General Hospital of Western Theater Command were selected as the research objects.The patients were divided into the control group and the experimental group by random number table method,with 31 cases in each group.The control group was induced by propofol 2 mg/kg+sufentanil 0.5μg/kg+cisatracurium 0.2 mg/kg;the experimental group was induced by remazolam 0.3 mg/kg+sufentanil 0.5μg/kg+cisatracurium 0.2 mg/kg.After induction,visual double lumen bronchial catheter was placed in both groups to complete bronchial intubation.Mean arterial pressure(MAP)and heart rate(HR)were recorded at five minutes after entering the chamber(T0),at the time of loss of consciousness(T1),immediately before intubation(T2),three minutes after intubation(T3),and 10 minutes after intubation(T4).The occurrence of hypotension and bradycardia during induction were recorded.Serum level of adrenocorticotropic hormone(ACTH)and norepinephrine(NA)were detected by enzyme-linked immunosorbent assay(ELISA)using 3 mL of venous blood collected from patients at T0,T2 and T4.Results Compared with T0,the MAP of patients in the control group at T1-T4 was significantly decreased,and the HR at T1,T2 and T4 was significantly decreased,the differences were statistically significant(P<0.05).Compared with the control group,the MAP and HR at T1-T4 in the experimental group increased significantly,the differences were statistically significant(P<0.05).Compared with T0,the ACTH and NA levels of patients in the control group at T2,T4 were significantly increased,the differences were statistically significant(P<0.05).Compared with the control group,the ACTH and NA at T2,T4 in the experimental group decreased significantly,the diff
作者
黄青青
代雪梅
曾镜铮
施琴
吴肖
徐帅
巩固
HUANG Qingqing;DAI Xuemei;ZENG Jingzheng;SHI Qin;WU Xiao;XU Shuai;GONG Gu(Department of Anesthesiology,General Hospital of Western Theater Command,Chengdu,Sichuan 610083,China;Department of Anesthesiology,North Sichuan Medical College,Nanchong,Sichuan 637000,China)
出处
《重庆医学》
CAS
2023年第5期705-709,共5页
Chongqing medicine
基金
2019军队后勤科研项目(CLB19J051)。
关键词
瑞马唑仑
丙泊酚
胸科手术
气管插管全身麻醉
应激
remazolam
propofol
thoracic surgery
trachea intubation general anesthesia
stress
