摘要
目的观察瑞马唑仑注射剂联合瑞芬太尼注射剂在老年胸腔镜手术中的应用效果。方法将择期进行胸腔镜手术的老年患者分为对照组和试验组。对照组静脉注射丙泊酚2 mg·kg^(-1)诱导麻醉,静脉泵注丙泊酚4~12 mg·kg^(-1)·h^(-1)+静脉输注瑞芬太尼0.05~0.20μg·kg^(-1)·h^(-1)维持;试验组静脉泵注瑞马唑仑12 mg·kg^(-1)·h^(-1)进行诱导,静脉泵注瑞马唑仑0.5~1.0 mg·kg^(-1)·h^(-1)+静脉输注瑞芬太尼0.05~0.20μg·kg^(-1)·h^(-1)维持。比较2组患者的镇痛镇静效果、炎症因子和血流动力学指标。结果对照组51例和试验组52例。术后2 h和术后12 h时,试验组的视觉模拟评分分别为(3.11±0.42)和(4.07±0.54)分,对照组分别为(3.45±0.36)和(4.92±0.73)分,差异均有统计学意义(均P<0.05)。试验组和对照组的意识消失时间分别为(87.38±13.58)和(79.24±11.27)s,术中瑞芬太尼用量分别为(2175.63±97.58)和(2254.84±135.62)μg,差异均有统计学意义(均P<0.05)。术后24 h时,试验组的白细胞介素(IL)-6、IL-8和C反应蛋白(CRP)分别为(18.67±4.86)ng·L^(-1)、(21.83±5.92)ng·L^(-1)和(43.68±9.45)mg·L^(-1),对照组分别为(31.85±5.47)ng·L^(-1)、(39.47±6.62)ng·L^(-1)和(68.94±12.98)mg·L^(-1),差异均有统计学意义(均P<0.05)。气管插管后-单肺通气前(T1)时,试验组的心率、收缩压、舒张压、血氧饱和度分别为(73.46±10.37)次/分、(114.62±8.95)mmHg、(78.96±11.75)mmHg和(97.26±0.92)%,对照组为(66.72±9.21)次/分、(99.74±10.52)mmHg、(73.59±10.23)mmHg和(95.87±0.95)%,差异均有统计学意义(均P<0.05)。结论瑞马唑仑注射剂联合瑞芬太尼注射剂在老年胸腔镜手术中镇痛镇静效果良好,可抑制炎症因子水平,并稳定患者单肺通气后血流动力学。
Objective To observe the clinical effect of remimazolam combined with remifentanil in elderly patients undergoing thoracoscopy.Methods The elderly patients undergoing elective thoracoscopy were divided into control group and treatment group.The control group was given intravenous injection of propofol(2 mg·kg^(-1))to induce anesthesia,and then was given intravenous infusion of propofol(4-12 mg·kg^(-1)·h^(-1))and remifentanil(0.05-0.20μg·kg^(-1)·h^(-1)).The treatment group was given intravenous injection of remimazolam(12 mg·kg^(-1)·h^(-1))for induction,and then was given intravenous infusion of remimazolam(0.5-1.0 mg·kg^(-1)·h^(-1))and remifentanil(0.05-0.20μg·kg^(-1)·h^(-1)).The analgesic and sedative effect,inflammatory factors and hemodynamics indexes were compared between the two groups.Results There were 51 cases in control group and 52 cases in treatment group.At 2 h and 12 h after surgery,visual analogue scores of treatment group were(3.11±0.42)points and(4.07±0.54)points,while those in control group were(3.45±0.36)points and(4.92±0.73)points,with statistical significance(all P<0.05).The absence time of consciousness in treatment group and control group were(87.38±13.58)and(79.24±11.27)s;the intraoperative dosage of remifentanil were(2175.63±97.58),(2254.84±135.62)μg;the differences were statistically significant(all P<0.05).At 24 h after operation,interleukin(IL)-6,IL-8 and C-reactive protein(CRP)in treatment group were(18.67±4.86)ng·L^(-1),(21.83±5.92)ng·L^(-1) and(43.68±9.45)mg·L^(-1),respectively,which in control group were(31.85±5.47)ng·L^(-1),(39.47±6.62)ng·L^(-1),(68.94±12.98)mg·L^(-1);the differences were statistically significant(all P<0.05).The heart rate,systolic blood pressure,diastolic blood pressure and oxygen saturation after endotractive intubation and before single lung ventilation(T1)of treatment group were(73.46±10.37)times·min^(-1),(114.62±8.95)mmHg,(78.96±11.75)mmHg and(97.26±0.92)%,respectively,which in control group were(66.72±9.21)times·min^(
作者
陈慧
王佳
张春明
CHEN Hui;WANG Jia;ZHANG Chun-ming(Department of Anesthesiology,The Second Hospital of Nanjing,Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing 210003,Jiangsu Province,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2023年第11期1552-1556,共5页
The Chinese Journal of Clinical Pharmacology
