Effect of remimazolam on wake quality,cerebral oxygen metabolism and quantitative EEG indexes in elderly patients with hip arthroplasty
Objective To investigate the effects of remimazolam on the awakening quality,cerebral oxy-gen 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 dur-ing 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,he-modynamic indexes,cerebral oxygen metabolism indexes[arterial-internal jugular vein oxygen content differ-ence(Da-jvO2),cerebral oxygen uptake rate(CEO2)],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 extuba-tion 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 experi-mental group were higher than those in the control group,and the differences were statistically significant(P＜0.05).Da-jvO2 and CEO2 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 group was higher than that in the control group,and the differ-ence was statistically significant(P＜0.001).The MMSE score at 24 h and 72 h after surgery in the experi-mental group was higher than that in the control group,the incidence rate of POCD was lower than that in the control group,and the differences were statistically significant(P＜0.05).The use rate of phenylephrine and ephedrine in the experimental group was lower than that in the control group,and the difference was statisti-cally significant(P＜0.05).The incidence rates of hypotension and postoperative respiratory depression in the experimental group were lower than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion Remimazolam use in elderly patients with hip arthroplasty is conducive to hemody-namic stability during surgery,and could improve the quality of awakening,cerebral oxygen metabolism and e-lectroencephalogram alpha band power spectral density,reduce cognitive impairment,decrease the incidence rate of POCD with high safety.
remimazolamgeriatric hip replacementawakening qualitycerebral oxygen metabolismquantitative EEG indicators
万方数据
维普
