Effects of Different Doses of Remazolam Combined with Ropivacaine for Combined Spinal-epidural Anesthesia in Elderly Patients Undergoing Hip Replacement
Objective:To investigate the effect of different doses of Remazolam combined with Ropivacaine spinal-epidural anesthesia on elderly patients undergoing hip replacement.Method:A total of 103 elderly patients with hip replacement admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from June 2022 to April 2023 were selected as the study objects and randomly divided into R2 group(n=51)and R4 group(n=52).The R2 group was given 2 μg/(kg·min)Remazolam combined with Ropivacaine,and the R4 group was given 4 μg/(kg·min)Remazolam combined with Ropivacaine.The depth of sedation[bispectral index(BIS),modified observational assessment of alertness and sedation(MOAA/S)],postoperative pain score,duration of sedation onset,number of sedation recovery,recovery time,hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2)]and the occurrence of adverse reactions were compared between the two groups.Result:There were statistically significant differences in the comparison of MOAA/S score,BIS,MAP,SpO2,HR between-group,time points,and interactions between the two groups(P<0.05).At 5 min,20 min and 45 min after sedation,BIS,MOAA/S score,MAP,SpO2 and HR in R2 group were higher than those in R4 group,and the differences were statistically significant(P<0.05).The onset time of sedation in R2 group was longer than that in R4 group,the recovery time was shorter than that in R4 group,and the number of sedation recovery was higher than that in R4 group,the differences were statistically significant(P<0.05).There were no statistically significant differences in pain analogue scale(VAS)scores between the two groups at different group,time points and interactions(P>0.05).There were no significant differences in VAS scores between the two groups at 6 h,12 h and 24 h after surgery(P>0.05).The total incidence of adverse reactions in R2 group was 19.61%,which was lower than 71.15%in R4 group,and the difference was statistically significant(P<0.05).Conclusion:Different doses of Remazolam combined with Ropivacaine spinal-epidural anesthesia have no significant difference in the analgesic effect of elderly patients undergoing hip replacement,but the recovery time of patients undergoing low-dose anesthesia is shorter,which can not only satisfy the sedation depth,but also ensure the intraoperative safety and stable hemodynamic indexes,and have fewer adverse reactions.
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