The Impact of remimazolam besylate on Emergence Delirium and Postoperative Cognitive Dysfunction in Geriatric Patients Undergoing Lumbar Spine Surgery Under General Anesthesia During the Intraoperative Maintenance Phase
The Impact of remimazolam besylate on Emergence Delirium and Postoperative Cognitive Dysfunction in Geriatric Patients Undergoing Lumbar Spine Surgery Under General Anesthesia During the Intraoperative Maintenance Phase
荣壮飞 1魏登荣 1陈丽萍 1胡成云 2唐朝亮2
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作者信息
1. 合肥京东方医院麻醉科,安徽合肥 230011
2. 中国科学技术大学附属第一医院麻醉科,安徽合肥 230001
折叠
摘要
目的 分析苯磺酸瑞马唑仑用于老年全身麻醉腰椎手术患者维持期,对苏醒质量及认知功能的影响.方法 选取2021年9月至2023年4月于合肥京东方医院择期行全身麻醉腰椎手术的老年患者60例,采用随机数字表法分为丙泊酚组(n=30)和瑞马唑仑组(n=30).丙泊酚组泵注瑞芬太尼+丙泊酚维持麻醉,瑞马唑仑组泵注瑞芬太尼+瑞马唑仑维持麻醉.比较两组不同时间点的麻醉相关指标及术后48 h内不良反应发生情况.结果 瑞马唑仑组T2、T3时间点平均动脉压(MAP)和心率(HR)、拔管后Ramsay镇静评分及术后24 h、48 h MoCA评分和MMSE评分均高于丙泊酚组(P＜0.05).瑞马唑仑组苏醒时间、拔管时间均短于丙泊酚组,血管活性药物使用率、术后48 h内低血压和注射痛发生率均低于丙泊酚组(P＜0.05).结论 相较于丙泊酚,苯磺酸瑞马唑仑用于老年全身麻醉腰椎手术患者维持期更加有利于稳定血流动力学,提高镇静效果和苏醒质量,对患者术后认知功能的影响更小,同时减少不良反应的发生.
Abstract
Objective To analyze the effects of remimazolam besylate on recovery quality and cognitive function during maintenan-remimazolam besylatece period in elderly patients undergoing lumbar surgery under general anesthesia.Methods 60 elderly patients who underwent elective lumbar surgery under general anesthesia in Hefei BOE Hospital from September 2021 to April 2023 were select-ed and divided into propofol group(n=30)and remimazolam group(n=30)by the random number table method.The propofol group was injected with remifentanil+propofol for anesthesia maintenance,and the remimazolam group was injected with remifentanil+remimazolam to maintain anesthesia.The anesthesia related indicators and incidence of adverse reactions within 48 hours after surgery were compared between two groups at different time points.Results MAP and HR at T2 and T3,Ramsay sedation score after extuba-tion,MoCA score and MMSE score at 24 h,48 h after surgery in remimazolam group were higher than those in propofol group(P＜0.05).The recovery time and extubation time in remimazolam group were shorter than those in propofol group,and the frequency of ap-plication of vasoactive drugs,incidence rates of hypotension and injection pain within 48 h after surgery were lower than those in propo-fol group(P＜0.05).Conclusion Compared with propofol,remimazolam besylate is more beneficial to stabilize the hemodynamics and enhance sedation effect and recovery quality during maintenance period in elderly patients undergoing lumbar surgery under general anesthesia,and the latter one has less impact on postoperative cognitive function and can reduce the occurrence of adverse reactions.
关键词
苯磺酸瑞马唑仑/老年/全身麻醉/腰椎手术/苏醒质量/认知功能
Key words
remimazolam besylate/elderly/general anesthesia/lumbar surgery/recovery quality/cognitive function
维普
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