首页|瑞马唑仑对肝切除术患者术后苏醒质量及认知功能的影响

瑞马唑仑对肝切除术患者术后苏醒质量及认知功能的影响

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目的:观察瑞马唑仑对肝切除术患者术后苏醒质量及认知功能的影响,探讨其临床价值.方法:选择赣南医学院第一附属医院 2022 年 1 月—2023 年 8 月收治的需行肝切除手术患者 60 例,随机分为两组,对照组采取丙泊酚、芬太尼、顺阿曲库铵麻醉诱导,泵注丙泊酚、瑞芬太尼麻醉维持;观察组静脉注射苯磺酸瑞马唑仑、芬太尼、顺阿曲库铵麻醉诱导,泵注苯磺酸瑞马唑仑、瑞芬太尼麻醉维持.比较两组不同时刻生命体征、苏醒质量指标、术后认知功能,并测定血浆中枢神经特异性蛋白(S100β)、神经元特异性烯醇化酶(NSE)水平及统计两组不良反应发生情况.结果:两组入室后(T0)、麻醉诱导后(T1)、切皮时(T2)、手术 1 h时(T3)、手术结束时(T4)、拔除气管导管时(T5)、出恢复室(T6)平均动脉压(MAP)及心率(HR),以及术前 1 d、术后 1 d、术后 3 d简易智能量表(MMSE)评分、血浆S100β、NSE水平比较差异均无统计学意义(P>0.05);观察组T5 时刻的HR水平高于T0 时刻,差异有统计学意义(P<0.05).观察组呼吸恢复时间、睁眼时间、拔管时间及恢复室停留时间均早于或者短于对照组,差异均有统计学意义(P<0.05),且观察组不良反应发生率(10.0%)低于对照组(33.3%),差异有统计学意义(P<0.05).结论:瑞马唑仑应用于肝切除术患者苏醒时间短,且不影响认知功能,不良反应发生率更低.
Effects of Remimazolam on Recovery Quality and Postoperative Cognitive Dysfunction in Patients with Hepatectomy
Objective:To observe the effects of Remimazolam on postoperative recovery quality and cognitive function in patients with hepatectomy,and to discuss its clinical value.Method:A total of 60 patients requiring hepatectomy admitted to the First Affiliated Hospital of Gannan Medical University from January 2022 to August 2023 were randomly divided into two groups.The control group was induced by Propofol,Fentanyl,Cisatracurium,and anesthesia maintained by pump injection of Propofol and Remifentanil.The observation group was induced by intravenous Remimazolam Tosilate,Fentanyl and Cisatracurium,and maintained by pump injection of Remimazolam Tosilate and Remifentanil.The vital signs,recovery quality indexes and postoperative cognitive function of the two groups were compared.The levels of plasma central nerve specific proteins(S100β)and neuron-specific enolase(NSE)were measured and the incidence of adverse reactions was statistically analyzed.Result:The mean arterial pressure(MAP)and heart rate(HR)after entry(T0),after anesthesia induction(T1),skin resection(T2),1 h after operation(T3),at the end of operation(T4),at the time of tracheal catheter removal(T5),and at leaving the recovery room(T6)had no significant differences,and MMSE scores,plasma S100β and NSE levels preoperative 1 d,postoperative 1 d,and postoperative 3 d had no significant differences(P>0.05);the HR level of the observation group at T5 was higher than that at T0,the difference was statistically significant(P<0.05).Respiratory recovery time,eye opening time,extubation time and recovery room residence time in the observation group were earlier or lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group(10.0%)was lower than that(33.3%)in the control group,the difference was statistically significant(P<0.05).Conclusion:Remimazolam can be used in patients undergoing hepatectomy with shorter recovery time,and it does not affect cognitive function,and lower incidence of adverse reactions.

RemimazolamHepatectomyAwakening qualityCognitive function

卓明、刘金龙、钟茂林、王辉、黄可女、叶军明

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赣南医学院第一附属医院麻醉科 江西 赣州 341000

南昌县人民医院麻醉科 江西 南昌 330200

瑞马唑仑 肝切除术 苏醒质量 认知功能

赣州市2021年指导性科技计划项目

GZ2021ZSF076

2024

中国医学创新
中国保健协会

中国医学创新

影响因子:1.706
ISSN:1674-4985
年,卷(期):2024.21(5)
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