摘要
目的评估瑞马唑仑联合瑞芬太尼用于衰弱老年患者电子支气管镜检查的安全性和有效性。方法选取2023年3月至2024年3月宣城市人民医院住院行电子支气管镜检查的58例衰弱老年患者,将患者随机分为2组:瑞马唑仑组(R组)和丙泊酚组(P组),每组各29例。静脉注射依托咪酯、泵注瑞芬太尼行麻醉诱导,R组静脉注射苯磺酸瑞马唑仑并泵注维持麻醉,P组静脉注射丙泊酚后泵注维持麻醉。达到镇静深度后置入喉罩,开始电子支气管镜检查。在术前1日访视和离室前对患者进行简易精神状态评价量表(MMSE)评分。记录诱导前(T0)、置入喉罩时(T1)、置入气管镜时(T2)、镜检结束(T3)和患者苏醒时(T4)的血压(BP)、心率(HR)、脑电双频谱指数BIS值、血氧饱和度(SpO_(2))值;记录2组患者苏醒时间、定向力恢复时间、术中和术后不良反应发生率。结果2组患者一般情况、检查时间、MMSE评分比较差异无统计学意义(P>0.05)。P组患者在T1、T2、T3时的收缩压、舒张压、心率、BIS值低于R组,差异有统计学意义(P<0.05)。P组定向力苏醒时间和定向力恢复时间较R组延长(P<0.05)。P组患者注射痛和低氧血症、低血压、心动过缓、呼吸抑制发生率多于R组(P<0.05)。结论瑞马唑仑联合瑞芬太尼应用在衰弱老年患者电子支气管镜检查中,镇静效果较好,血流动力学较稳定,对呼吸抑制轻,苏醒快且对认知功能无明显影响,不良反应少,是安全有效的。
Objective To evaluate the safety and efficacy of remimazolam combined with remifentanil for electronic bronchoscopy in frail elderly patients.Methods A total of 58 frail elderly patients undergoing electronic bronchoscopy at Xuancheng People′s Hospital from March 2023 to March 2024 were randomly divided into two groups:remazolam group(group R)and propofol group(group P),with 29 cases in each group.Anest-hesia induction was performed with intravenous injection of etomidate and pump-infusion of remifentanil.The R group received intravenous injection of remimazolam benzenesulfonate and pump-infusion for maintenance of anesthesia,while the P group received intravenous injection of propofol followed by pump-infusion for mainte-nance of anesthesia.A laryngeal mask was inserted once the sedation depth was achieved,and electronic bronchoscopy was initiated.The Mini-Mental State Examination(MMSE)score was assessed on the day before surgery and before leaving the room.Blood pressure(BP),heart rate(HR),bispectral index(BIS)values,and SpO_(2) values were recorded at pre-induction(T0),laryngeal mask insertion(T1),tracheal scope insertion(T2),end of bronchoscopy(T3),and patient awakening(T4).The time of awakening,orientation recovery time,and the incidence of intraoperative and postoperative adverse reactions were recorded for both groups.Results There were no statistically significant differences in general conditions,examination time,and MMSE scores between the two groups(P>0.05).At T1,T2,and T3,the systolic blood pressure,diastolic blood pressure,heart rate,and BIS values in the P group were lower than those in the R group,with statistically significant differences(P<0.05).The time to orientation awakening and orientation recovery time in the P group were longer than in the R group(P<0.05).The incidence of injection pain and hypoxemia,hypotension,bradycardia,and respiratory depression in the P group was higher than in the R group(P<0.05).Conclusion Remimazolam combined with remifentanil has good sedation effects,stable hemodynamics,mild respiratory depression,rapid awakening,and no obvious impact on cognitive function in patients undergoing electronic bronchoscopy.It has fewer adverse reactions and was safe and effective.
作者
张晓琴
陈学东
詹锐
沈齐庆
曹亚红
赵娟
Zhang Xiaoqin;Chen Xuedong;Zhan Rui;Shen Qiqing;Cao Yahong;Zhao Juan(Department of Anesthesiology,Xuancheng City Hospital,Anhui 242000,China)
出处
《山西医药杂志》
2025年第15期1123-1128,共6页
Shanxi Medical Journal
基金
安徽省科学技术计划项目(202304295107020069)。
