摘要
目的探讨瑞马唑仑用于老年患者全麻诱导的安全性与有效性。方法前瞻性选取2024年2至7月在宁波市医疗中心李惠利医院择期气管插管全麻患者80例,按随机数字表法分为丙泊酚组和瑞马唑仑组,每组40例。麻醉诱导时,丙泊酚组给予丙泊酚2 mg/kg,瑞马唑仑组给予瑞马唑仑0.3 mg/kg。两组患者均静脉注射舒芬太尼0.3μg/kg和罗库溴铵0.6 mg/kg。观察两组患者在入手术室后(T_(0))、气管插管前(T_(1))、气管插管1 min后(T_(2))、气管插管2 min后(T_(3))和气管插管3 min后(T_(4))的平均动脉压(MAP)和心率变化,以及不良反应发生情况。结果瑞马唑仑组T1时的MAP高于丙泊酚组(P<0.001),其余时点的MAP比较差异均无统计学意义(均P>0.05)。两组患者不同时点的心率比较差异均无统计学意义(均P>0.05)。瑞马唑仑组注射痛、低血压发生率明显低于丙泊酚组,差异均有统计学意义(均P<0.05),但心动过缓发生率比较差异无统计学意义(P>0.05)。结论瑞马唑仑0.3 mg/kg可安全应用于老年患者的诱导全麻,与丙泊酚全麻相比,能够减轻老年患者麻醉诱导时的血流动力学波动,提高麻醉诱导的安全性,并且无注射痛。
Objective To investigate the safety and efficacy of remimazolam in general anesthesia induction of elderly patients.Methods A prospective study was conducted on 80 patients scheduled for elective endotracheal intubation under general anesthesia at Ningbo Medical Center Lihuili Hospital from February to July 2024.The patients were randomly divided into two groups using a random number table:the propofol group(n=40)and the remimazolam group(n=40).During anesthesia induction,the propofol group received propofol 2 mg/kg,while the remimazolam group received remimazolam 0.3 mg/kg.Both groups were intravenously administered sufentanil 0.3μg/kg and rocuronium 0.6 mg/kg.Mean arterial pressure(MAP)and heart rate(HR)changes were observed at the following time points:upon entering the operating room(T_(0)),before endotracheal intubation(T_(1)),1 minute after intubation(T_(2)),2 minutes after intubation(T_(3)),and 3 minutes after intubation(T_(4)).The incidence of adverse reactions was also recorded.Results The MAP level in the remimazolam group at T1 was significantly higher than that of the propofol group(P<0.001),but there were no significant differences in MAP at other time points(all P>0.05).No significant differences in HR were observed between the two groups at any time point(all P>0.05).The incidence of injection pain and hypotension in the remimazolam group was significantly lower than that of the propofol group(both P<0.05),but there was no significant difference in the incidence of bradycardia(P>0.05).Conclusion Remimazolam 0.3 mg/kg can be safely used for anesthesia induction in elderly patients.Compared with propofol,remimazolam reduces hemodynamic fluctuations during anesthesia induction,improves safety,and eliminates injection pain.
作者
陈倩倩
潘志浩
顾俐妮
CHEN Qianqian;PAN Zhihao;GU Lini(Department of Anesthesiology,Ningbo Medical Center Lihuili Hospital,Ningbo 315041,China)
出处
《浙江医学》
2025年第4期414-417,共4页
Zhejiang Medical Journal
基金
恩泽疼痛管理医学研究项目(ezmr2022-004)。
关键词
瑞马唑仑
丙泊酚
老年患者
全麻
诱导后低血压
Remimazolam
Propofol
Elderly patients
General anesthesia
Post-induction hypotension
