摘要
目的研究瑞马唑仑对老年髋关节置换术患者苏醒质量、脑氧代谢及定量脑电图指标的影响。方法选取2021年1月至2023年1月亳州市人民医院老年髋关节置换术患者92例作为研究对象,随机分为对照组和试验组,每组46例。试验组全身麻醉诱导使用瑞马唑仑0.1 mg/kg,1 min内静脉注射完毕,术中以0.1 mg·kg^(-1)·h^(-1)持续静脉泵入直至术毕。对照组全身麻醉诱导使用咪达唑仑0.05 mg/kg,1 min内静脉注射完毕,术中以生理盐水0.1 mg·kg^(-1)·h^(-1)持续静脉泵入直至术毕。瑞马唑仑或咪达唑仑注射完成后使用其他药物继续诱导。比较两组围手术期指标,不同时间点的血流动力学指标,脑氧代谢指标[动脉-颈内静脉血氧含量差(Da-jvO_(2))、脑氧摄取率(CEO_(2))],脑电波alpha频段平均功率谱密度,简易智力检测量表(MMSE)评分,认知功能障碍(POCD)发生率,血管活性药物使用情况及围手术期不良事件发生率。结果试验组拔管时间、术后睁眼时间短于对照组,差异有统计学意义(P<0.05);试验组T 4、T 5时的平均动脉压(MAP)、心率(HR)高于对照组,差异有统计学意义(P<0.05);试验组T 4、T 5时的Da-jvO_(2)、CEO_(2)低于对照组,差异有统计学意义(P<0.05);试验组脑电波alpha频段平均功率谱密度高于对照组,差异有统计学意义(P<0.001);试验组术后24、72 h的MMSE评分高于对照组,POCD发生率低于对照组,差异有统计学意义(P<0.05);试验组去氧肾上腺素、麻黄碱使用率低于对照组,差异有统计学意义(P<0.05);试验组低血压、术后呼吸抑制发生率低于对照组,差异有统计学意义(P<0.05)。结论瑞马唑仑应用于老年髋关节置换术患者有利于稳定术中血流动力学,并可改善苏醒质量、脑氧代谢及脑电图alpha频段功率谱密度,减少认知功能损伤,降低POCD发生率,安全性较高。
Objective To investigate the effects of remimazolam on the awakening quality,cerebral oxygen metabolism and quantitative EEG indexes in elderly patients with hip arthroplasty.Methods A total of 92 elderly patients with hip arthroplasty in Bozhou Municipal People’s Hospital from January 2021 to January 2023 were selected as the study subjects and randomly divided into the control group and experimental group,46 cases in each group.The experimental group used remimazolam 0.1 mg/kg in general anesthesia,which was intravenously injected within 1 min,and intravenous pumping was continued at 0.1 mg·kg^(-1)·h^(-1) during the operation until the end of the operation.In the control group,midazolam 0.05 mg/kg was used for the induction of general anesthesia,which was injected intravenously within 1 min,and intravenous pumping was continued with normal saline 0.1 mg·kg^(-1)·h^(-1) during the operation until the operation end.Remimazolam or midazolam injection was completed to continue induction with other drugs.The perioperative indexes,hemodynamic indexes,cerebral oxygen metabolism indexes[arterial-internal jugular vein oxygen content difference(Da-jvO_(2)),cerebral oxygen uptake rate(CEO_(2))],average power spectral density of EEG alpha band,mini-intelligence test(MMSE)score,incidence rate of cognitive dysfunction(POCD),vasoactive drug use and incidence rate of perioperative adverse events were compared between the two groups.Results The extubation time and postoperative eye opening time in the experimental group were shorter than those in the control group,and the differences were statistically significant(P<0.05).MAP and HR at T4 and T5 in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).Da-jvO_(2) and CEO_(2) at T4 and T5 in the experimental group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The average power spectral density of EEG alpha band in the experimental grou
作者
王朋
邓海波
WANG Peng;DENG Haibo(Department of Anesthesiology,Bozhou Municipal People’s Hospital,Bozhou,Anhui 236800,China;Department of Anesthesiology,Fuyang Municipal People’s Hospital,Fuyang,Anhui 236000,China)
出处
《重庆医学》
CAS
2024年第23期3596-3601,共6页
Chongqing Medical Journal
基金
阜阳市卫生健康委科研项目(FY2021-032)。
关键词
瑞马唑仑
老年髋关节置换术
苏醒质量
脑氧代谢
定量脑电图指标
remimazolam
geriatric hip replacement
awakening quality
cerebral oxygen metabolism
quantitative EEG indicators
