| 不同剂量瑞马唑仑对老年冠心病患者非心脏手术全身麻醉诱导的效果分析 |
| 投稿时间：2025-02-03 修订日期：2025-02-24 点此下载全文 |
| 引用本文：周彪,崔鹏,胡杰,孙佳,刘雅君.不同剂量瑞马唑仑对老年冠心病患者非心脏手术全身麻醉诱导的效果分析[J].医学研究杂志,2025,54(8):129-133, 67 |
| DOI：
10.11969/j.issn.1673-548X.2025.08.021 |
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| 基金项目:河南省医学科技攻关项目(232102310221) |
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| 中文摘要:目的 观察不同剂量瑞马唑仑用于老年冠心病患者非心脏手术全身麻醉诱导的效果。方法 选取2023年10月～2024年10月于郑州大学附属洛阳中心医院择期接受气管插管下全身麻醉的老年冠心病非心脏手术患者120例,年龄60～85岁,按照随机数字表法将其分为3组:R1组、R2和R3组,每组各40例,单次推注瑞马唑仑剂量分别为0.2、0.25、0.3mg/kg。对比3组患者诱导前(T1)、改良警觉/镇静(modified observers assessment of alertness/sedation,MOAA/S)评分0分时(T2)、插管后15s(T3)不同时点平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、心排出量(cardiac output,CO)、每搏变异度(stroke volume variation,SVV)、系统血管阻力(systemic vascular resistance,SVR)、局部脑氧饱和度(regional cerebral oxygen saturation,rScO2)以及记录意识消失时间、血管活性药物使用情况、呃逆和低氧血症发生率等。结果 与T1时点比较,3组患者T2时点MAP、SVR均降低,R2组、R3组均明显低于R1组(P<0.05)；在T3时点,R1组MAP、HR均明显高于R2组、R3组,且R1组内比较T3时点高于T1时点(P<0.05)；3组患者CO、SVV及rScO2不同时点比较,差异均无统计学意义(P＞0.05)。意识消失时间随瑞马唑仑诱导剂量增加而缩短,R1组与R2组诱导期间艾司洛尔应用比例明显多于R3组(P<0.05)。3组不良事件发生率差异无统计学意义(P＞0.05)。结论 瑞马唑仑应用于老年冠心病患者的全身麻醉诱导是安全、有效的,其中0.3mg/kg麻醉诱导效果更佳。 |
| 中文关键词:瑞马唑仑 老年人 冠心病 全身麻醉诱导 |
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| Efficacy Analysis of Different Doses Remimazolam During Induction of General Anesthesia in Elderly Patients with Coronary Heart Disease Undergoing Non-cardiac Surgery. |
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| Abstract:Objective To observe the effects of different doses remimazolam during induction of anesthesia in elderly patients with coronary heart disease undergoing non-cardiac surgery. Methods A total of 120 elderly patients with non-cardiac surgery for coronary heart disease and received general anesthesia under tracheal intubation at Luoyang Central Hospital Affiliated to Zhengzhou University from October 2023 to October 2024, aged 60-85 years. The patients were divided into 3groups by random number table:group R1, group R2 and group R3, with 40 cases in each group, with anesthesia was induced with intravenous injection of remimazolam of 0.2,0.25,0.3mg/kg, respectively. Before induction (T1), modified observers assessment of alertness/sedation (MOAA/S) score reached to 0 points (T2), 15seconds after intubation (T3), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), stroke volume variation (SVV), systemic vascular resistance (SVR), and regional cerebral oxygen saturation (rScO2) were compared among the three groups, as well as the time to loss of consciousness, use of vasoactive drugs, and the incidence of hiccups and hypoxemia were recorded.ResultsCompared with the T1, MAP and SVR decreased significantly in all groups at T2, with group R2 and R3 showing lower values than group R1 (P<0.05); at T3, the MAP and HR in group R1 was higher than group R2 and group R3 compared with T1, the MAP and HR in group R1 were significantly increased at T3 (P<0.05). There was no significant difference in CO, SVV and rScO2among three groups at different time (P＞0.05). The time of loss of consciousness reduced with the increase of the dose of remimazolam. The application proportion of esmololhydrochloride in group R1and group R2 was more than group R3during induction of general anesthesia (P<0.05). There was no significant difference in incidence of adverse events among three groups (P＞0.05). Conclusion Remimazolam can be used safely and effectively for the induction of general anesthesia in elderly patients with coronary heart disease undergoing non-cardiac surgery, and doses of 0.3mg/kg is more effective for anesthesia induction. |
| keywords:Remimazolam Elderly patients Coronary heart disease Induction of anesthesia |
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