摘要
目的探讨瑞马唑仑联合艾司氯胺酮对老年患者腹腔镜手术后睡眠节律和谵妄的影响。方法目的选取2021年3月—2024年3月江苏大学附属武进医院收治的76例行腹腔镜手术的老年患者为研究对象,按照麻醉方式不同分为两组,各38例,对照组采用咪达唑仑联合丙泊酚进行麻醉诱导,研究组麻醉诱导方式采用瑞马唑仑联合艾司氯胺酮。对比两组术前1 d及术后1、3、7 d的睡眠质量评分、失眠情况、褪黑素水平、术后谵妄发生情况。结果术后1、3 d,研究组匹兹堡睡眠质量指数评分分别为(12.68±2.19)分、(8.13±1.71)分,明显低于对照组的(13.76±2.28)分、(10.88±2.56)分,差异均有统计学意义(t=2.106,5.506;P均<0.05)。术后1、3 d,研究组阿森斯失眠量表评分低于对照组,褪黑素浓度高于对照组,差异均有统计学意义(P均<0.05)。研究组谵妄发生率为5.26%(2/38),低于对照组的21.05%(8/38),差异有统计学意义(χ^(2)=4.146,P<0.05)。结论瑞马唑仑联合艾司氯胺酮对老年患者腹腔镜手术后睡眠节律的改善和谵妄的预防具有积极作用。
Objective To investigate the effect of remazolam combined with esketamine on sleep rhythm and delirium in elderly patients after laparoscopic surgery.Methods A total of seventysix elderly patients who underwent laparo⁃scopic surgery in Wujin Hospital Affiliated to Jiangsu University from March 2021 to March 2024 were purposefully selected and divided into two groups according to different anesthesia methods,with thirtyeight cases in each group.The control group was treated with midazolam combined with propofol for anesthesia induction,and the study group was treated with remifentanil combined with esketamine for anesthesia induction.The sleep quality score,insomnia,melatonin level and postoperative delirium were compared between the two groups at 1 d before operation,1,3 and 7 d after operation.Results On the 1 and 3 day after operation,the Pittsburgh Sleep Quality Index scores of the study group were 12.68±2.19 and 8.13±1.71,which were significantly lower than 13.76±2.28 and 10.88±2.56 of the control group,and the differences were statistically significant(t=2.106,5.506;both P<0.05).On the 1 and 3 d after opera⁃tion,the Athens Insomnia Scale score of the study group was lower than that of the control group,and the melatonin concentration was higher than that of the control group,the differences were statistically significant(all P<0.05).The incidence of delirium in the study group was 5.26%(2/38),which was lower than 21.05%(8/38)in the control group,and the difference was statistically significant(χ^(2)=4.146,P<0.05).Conclusion Remazolam combined with esketamine has a positive effect on the improvement of sleep rhythm and the prevention of delirium in elderly patients after laparo⁃scopic surgery.
作者
薛志鹏
刘彬
XUE Zhipeng;LIU Bin(Department of Anesthesiology,Wujin Hospital Affiliated to Jiangsu University(Wujin Clinical College of Xuzhou Medical University),Changzhou 213000,Jiangsu,China)
出处
《系统医学》
2025年第11期72-75,共4页
Systems Medicine
关键词
瑞马唑仑
艾司氯胺酮
腹腔镜术后
老年患者
睡眠节律
谵妄
Remazolam
Esketamine
After laparoscopic surgery
Elderly patients
Sleep rhythm
Delirium
作者简介
薛志鹏(1990-),男,本科,主治医师,主要从事临床麻醉学研究;通信作者:刘彬(1986-),男,本科,副主任医师,主要从事临床麻醉学研究,E-mail:zp2000dl@163.com。
