Effects of Remimazolam Combined with Dexmedetomidine on Cerebral Oxygen Metabolism and Cog-nitive Function in Elderly Patients Undergoing Lumbar Spine Surgery
[Objective]To investigate the effects of remimazolam combined with dexmedetomidine(Dex)on cerebral oxygen metabolism and cognitive function in elderly patients undergoing lumbar spine surgery.[Methods]A total of 126 elderly patients undergoing lumbar spine surgery were randomly divided into three groups:the remimazolam group(Group A),the Dex group(Group B),and the combined group(Group C),with 42 patients in each group.All patients received total intravenous anesthesia.Group A received remimazolam,Group B received Dex,and Group C received a combination of remimazolam and Dex.Hemodynamic parameters,cerebral oxygen metabolism indicators,and cognitive function were compared at five time points:pre-anesthesia(T0),10 minutes after drug injection(T1),at tracheal intubation(T2),15 minutes before the end of surgery(T3),and at the end of surgery(T4),as well as the cognitive function at T0,24 hours postoperatively(T5),and 48 hours postoperatively(T6).[Results]Patients in group C had a lower heart rate(HR)at T4 and T2 compared to groups A and B(P＜0.05).The mean arterial pressure(MAP)in group C was lower than that in groups A and B from T1、T2、T3 T4(P＜0.05).The cerebral oxygen extraction rate(CEO2)and the arteriovenous oxygen content difference(Da-jvO2)in group C were lower than those in groups A and B during T1、T2、T3、T4,while the jugular venous bulb oxygen saturation(SjvO2)in group C was higher than that in groups A and B(P＜0.05).The MMSE scores of patients in group C at T5 and T6 were significantly higher than those in groups A and B(P＜0.05).[Conclusion]Remimazolam combined with Dex anesthesia effectively improves hemodynamic stability,enhances cerebral oxygen metabo-lism,and significantly improves cognitive function in elderly patients undergoing lumbar spine surgery,warranting clinical promotion.
万方数据
维普
