首页|瑞马唑仑对老年NSCLC根治性手术患者手术应激反应、术后苏醒期质量及拔管时间的影响

瑞马唑仑对老年NSCLC根治性手术患者手术应激反应、术后苏醒期质量及拔管时间的影响

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[目的]探讨瑞马唑仑对老年非小细胞肺癌(NSCLC)根治性手术患者应激反应、术后苏醒期质量及拔管时间的影响.[方法]在新乡医学院第一附属医院行 NSCLC 根治性手术的 80 例患者随机分为两组,每组 40 例,对照组使用丙泊酚进行麻醉诱导和维持,观察组使用瑞马唑仑进行麻醉诱导和维持.比较两组手术前后肾上腺皮质激素(ACTH)和一氧化氮(NO)水平;比较两组患者麻醉诱导前(T1)、插管 1 min内(T2)、手术开始后 30 min(T3)、手术完成时(T4)、拔管 10 min后(T5)的心率(HR)和平均动脉压(MAP);比较两组患者术后苏醒期恢复质量及呛咳发生情况.[结果]与术前相比,两组患者术后 ACTH 水平明显升高,NO 水平显著降低(P<0.05),但组间比较差异无统计学意义(P>0.05).两组 T2、T3 时较 HR 及 MAP 水平均T1 时明显降低(P<0.05),观察组T2 时 HR及 MAP水平高于对照组(P<0.05).两组患者苏醒期脑电双频谱指数(BIS)、术后视觉模拟评分法(VAS)评分、躁动情况比较,差异无统计学意义(P>0.05).观察组患者的睁眼时间、拔管时间及患者在麻醉后监测治疗室(PACU)停留时间均短于对照组(P<0.05).观察组呛咳发生率低于对照组(P<0.05).[结论]在老年患者行 NSCLC根治性手术时使用瑞马唑仑麻醉诱导,有利于维持血流动力学稳定,提高患者的苏醒期质量,降低拔管呛咳的发生率.
The Effect of Remimazolam on Surgical Stress Response,Quality of Postoperative Recovery,and Extubation in Elderly Patients Undergoing Radical Surgery for NSCLC
[Objective]To explore the effects of remimazolam on stress response,postoperative recovery quality,and extubation in elderly patients undergoing radical surgery for non-small cell lung cancer(NSCLC).[Methods]Eighty patients undergoing radical NSCLC surgery in The First Affiliated Hospital of Xinxiang Medical University were randomly divided into two groups,with 40 patients in each group.The control group received propofol,while the observation group was induced and maintained with remimazolam anesthesia.Lev-els of adrenocorticotropic hormone(ACTH)and nitric oxide(NO)were compared pre-surgery and post-surgery between the two groups.Additionally,heart rate(HR)and mean arterial pressure(MAP)were compared at different time points:before anesthesia induction(T1),within 1 minute of intubation(T2),30 minutes after surgery started(T3),at the end of surgery(T4),and 10 minutes after extubation(T5).Postoperative recovery quality and the incidence of coughing were also compared between the groups.[Results]Compared to pre-sur-gery levels,both groups showed a significant increase in ACTH level and a decrease in NO level(P<0.05),but there was no significant difference between the groups(P>0.05).Both groups had significantly lower HR and MAP at T2 and T3 compared to T1(P<0.05).HR and MAP levels at T2 were higher in the observation group compared to the control group(P<0.05).There was no significant difference between the two groups in terms of postoperative recovery quality measured by bispectral index(BIS),postoperative visual analogue scale(VAS)scores,and agitation(P>0.05).The observation group had shorter eye-opening time,extubation time,and duration of stay in the post-anesthesia care unit(PACU)compared to the control group(P<0.05).The incidence of coughing was lower in the observation group(P<0.05).[Conclusion]The use of remimazo-lam for anesthesia induction in elderly patients undergoing radical NSCLC surgery can maintain hemodynamic stability,improve the quality of recovery period,and reduce the incidence of coughing during extubation.

Carcinoma,Non-Small-Cell Lung/SURemimazolamStress,PhysiologicalAnes-thesia Recovery Period

贾志杰、张晓冉、段文姣

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新乡医学院第一附属医院麻醉科,河南 新乡 453000

淇县人民医院麻醉科,河南 鹤壁 456700

癌,非小细胞肺/外科学 瑞马唑仑 应激,生理学 麻醉恢复期

2024

医学临床研究
湖南省医学会

医学临床研究

影响因子:0.595
ISSN:1671-7171
年,卷(期):2024.41(3)
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