摘要
目的 分析艾司氯胺酮复合瑞马唑仑在老年患者全身麻醉诱导中的应用效果。方法 选择140例住院并接受手术治疗的老年患者,采用数字随机方法分为研究组和对照组,每组70例。在麻醉诱导中,对照组采用咪达唑仑复合丙泊酚,研究组采用艾司氯胺酮复合瑞马唑仑。比较两组手术相关指标、镇静评分、麻醉期间及术后不良反应发生率以及不同时间的血压、心率、疼痛和认知评分。结果 研究组患者的麻醉时间、手术时间、复苏时间和对照组相比无统计学差异(P>0.05);研究组患者的镇静评分(1.19±0.43)分与对照组的(3.02±0.51)分相比更低,有统计学差异(P<0.05)。对照组患者插管前、插管3 min时的心率、舒张压和收缩压水平与麻醉前相比均降低,有统计学差异(P<0.05);研究组患者插管前的心率、舒张压和收缩压水平与麻醉前相比均降低(P<0.05)。研究组患者插管前、插管3 min时的心率、舒张压和收缩压水平均高于对照组,有统计学差异(P<0.05)。研究组患者麻醉期间不良反应发生率低于对照组,有统计学差异(P<0.05)。研究组和对照组术后不良反应发生率比较无统计学差异(P>0.05)。研究组术后24、72 h的简易智能精神状态检查量表(MMSE)评分分别为(24.31±1.85)、(26.28±2.05)分,高于对照组的(20.67±1.24)、(23.17±1.85)分,有统计学差异(P<0.05)。研究组术后4、12、24 h的视觉模拟评分法(VAS)评分分别为(4.05±1.18)、(2.14±1.04)、(1.75±0.29)分,低于对照组的(5.42±1.30)、(3.26±1.27)、(2.58±0.54)分,有统计学差异(P<0.05)。结论 艾司氯胺酮复合瑞马唑仑应用在老年患者全身麻醉诱导中对患者血流动力学影响小,同时能发挥出色的镇静、镇痛效果,并且对于老年患者来说安全性较好。
Objective To analyze the practical effect of esketamine combined with remazolam in induction of general anesthesia in elderly patients.Methods 140 elderly patients who were hospitalized and underwent surgical treatment were selected and divided into the study group and the control group using digital randomization method,with 70 cases in each group.In induction of anesthesia,the control group used midazolam combined with propofol,and the study group used esketamine combined with remazolam.Comparison was made on surgery-related indicators,sedation score,incidence of adverse reactions during and after anesthesia,and blood pressure,heart rate,pain and cognitive scores at different time points between the two groups.Results There was no significant difference in anesthesia time,operation time and resuscitation time between the study group and the control group(P>0.05).The sedation score of(1.19±0.43)points in the study group was lower than(3.02±0.51)points in the control group,and the difference was statistically significant(P<0.05).The levels of heart rate,diastolic blood pressure and systolic blood pressure before intubation and 3 min after intubation in the control group were decreased compared with those before anesthesia,and the difference was statistically significant(P<0.05).The levels of heart rate,diastolic blood pressure and systolic blood pressure before intubation in the study group were all decreased compared with those before anesthesia(P<0.05).The levels of heart rate,diastolic blood pressure and systolic blood pressure before intubation and 3 min after intubation in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions during anesthesia in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of postoperative adverse reactions between the study group and the control group(P>0.05).The Mini-Men
作者
付伟
王鹏
FU Wei;WANG Peng(Anesthesiology Department,Gaotang County People's Hospital,Liaocheng 252800,China)
出处
《中国实用医药》
2024年第21期25-29,共5页
China Practical Medicine
关键词
全身麻醉
麻醉诱导
艾司氯胺酮
瑞马唑仑
老年
General anesthesia
Induction of anesthesia
Esketamine
Remazolam
Old age
