摘要
目的探讨瑞马唑仑与咪达唑仑麻醉应用于老年股骨粗隆间骨折行股骨近端防旋髓内钉手术效果的差异。方法方便选取2023年2月—2024年4月通用环球中铁邳州医院行股骨近端防旋髓内钉手术治疗的71例老年股骨粗隆间骨折老年患者为研究对象,研究对象依据术中使用麻醉药物不同分为对照组(35例,麻醉诱导时使用咪达唑仑方案)与观察组(36例,麻醉诱导时使用瑞马唑仑方案)。对比两组围术期指标,脑电双频指数与血流动力指标、认知功能水平及并发症发生率。结果观察组的拔管时间(7.03±2.03)min、入睡时间(2.03±2.03)min均短于对照组的(13.25±2.36)min、(6.25±2.36)min,差异均有统计学意义(t=11.917,8.085;P均<0.05);但观察组手术时间、术中出血量与对照组相比,差异均无统计学意义(P均>0.05)。两组脑电双频指数值均呈先降低再升高的趋势,组间比较,差异均无统计学意义(P均>0.05)。两组心率、平均动脉压呈先升高再降低再升高的趋势,插管即刻时,观察组心率、平均动脉压较对照更平稳,差异均有统计学意义(P均<0.05)。观察组术后1、3 d的简易精神状态评价量表评分高于对照组,差异均有统计学意义(P均<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论手术采用瑞马唑仑麻醉相较于咪达唑仑表现出多重优势,能够缩短拔管与入睡时间、稳定血流动力学、加速认知功能恢复,最终提高手术安全性。
Objective To investigate the difference in the effect of remifentanil and midazolam anesthesia on proximal femoral antirotation intramedullary nail in elderly patients with intertrochanteric fracture.Methods From February 2023 to April 2024,seventy-one elderly patients with femoral intertrochanteric fractures who underwent proximal femoral antirotation intramedullary nail surgery in General Global Zhongtie Pizhou Hospital were conveniently se-lected as the research objects.The subjects were divided into control group(thirty-five cases,midazolam regimen was used during anesthesia induction)and observation group(thirty-six cases,remifentanil regimen was used during anes-thesia induction)according to the different anesthetic drugs used during operation.The perioperative indexes,bispec-tral index and hemodynamic indexes,cognitive function level and complication rate were compared between the two groups.Results The extubation time(7.03±2.03)min and sleep time(2.03±2.03)min in the observation group were shorter than(13.25±2.36)min,(6.25±2.36)min in the control group,and the differences were statistically significant(t=11.917,8.085;all P<0.05);however,there were no significant differences in operation time and intraoperative blood loss between the observation group and the control group(all P>0.05).Both groups exhibited a biphasic pattern in bispectral index values,initially decreasing before subsequently increasing,and there was no significant difference be-tween the two groups(all P>0.05).The heart rate and mean arterial pressure of the two groups showed a trend of in-creasing first,then decreasing and then increasing.At the time of intubation,the heart rate and mean arterial pressure of the observation group were more stable than those of the control group,and the differences were statistically signifi-cant(all P<0.05).The scores of Mini-mental State Examination in the observation group were higher than those in the control group at 1 and 3 days after operation,and the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Compared with midazolam,remifentanil-assisted anesthesia has multiple advantages,which can shorten the time of extubation and falling asleep,stabilize hemodynamics,accelerate the recovery of cognitive function,and ultimately improve the safety of surgery.
作者
褚巍
CHU Wei(Department of Anesthesiology,General Global Zhongtie Pizhou Hospital,Pizhou 221300,Jiangsu,China)
出处
《系统医学》
2025年第12期84-87,共4页
Systems Medicine
关键词
瑞马唑仑
咪达唑仑
股骨近端防旋髓内钉手术
股骨粗隆间骨折
认知功能
Remazolam
Midazolam
Proximal femoral nail antirotation surgery
Intertrochanteric fracture of femur
Cognitive function
