摘要
目的:探讨甲苯磺酸瑞马唑仑联合瑞芬太尼用于麻醉,对老年脊柱外科手术患者的效果,及其对血流动力学、血清白细胞介素-1β(IL-1β)、重组人趋化因子(CXCL8)水平的影响。方法:选用2022年5月至2023年5月本院行脊柱外科手术的老年患者88例,随机分为试验组和对照组。对照组给予瑞芬太尼,试验组在对照组的基础上联合甲苯磺酸瑞马唑仑进行麻醉。比较两组患者麻醉效果、血流动力学指标、血清IL-1β、CXCL8水平及并发症发生率。结果:经不同方案麻醉后,比较两组自主呼吸恢复时间、拔管时间、苏醒时间,试验组明显短于对照组(P<0.05);与给药前(T0)相比,给药1 min后(T1)、给药5 min后(T2)、给药10 min后(T3)、拔管后(T4)试验组血流动力学指标——心率(HR)、平均动脉压(MAP)波动幅度显著小于对照组(P<0.05)。手术后,两组血清中IL-1β、CXCL8含量明显增加(P<0.05),但试验组较对照组明显降低(P<0.05);且术后两组并发症发生率无统计学差异(P>0.05)。结论:对行脊柱外科手术的老年患者采用甲苯磺酸瑞马唑仑+瑞芬太尼联合麻醉效果较为理想,可有效降低炎性因子表达水平,缩短患者苏醒时间,临床应用价值较高。
AIM:To investigate the anesthetic ef-fect of remimazolam tosilate combined with remi-fentanil in elderly patients undergoing spinal sur-gery,and its impacts on hemodynamics,serum in-terleukin-1β(IL-1β)and C-X-C motif chemokine li-gand 8(CXCL8)level.METHODS:A total of 88 elder-ly patients who underwent spinal surgery in our hospital from May 2022 to May 2023 were random-ly separated into an experimental group and a con-trol group.The control group was given remifent-anil,and the experimental group was anesthetized with remimazolam tosilate on the basis of the con-trol group.The anesthesia effect,hemodynamic in-dicators,serum IL-1βand CXCL8 levels,and compli-cation rate were compared between two groups.RESULTS:After different anesthesia regimens,the recovery time of spontaneous respiration,extuba-tion time,and recovery time of the two groups were compared,and the experimental group were obviously shorter than the control group(P<0.05);compared with pre administration(T0),the fluctua-tion ranges of hemodynamic indexes,including heart rate(HR)and mean arterial pressure(MAP),in the experimental group after 1 min(T1),5 min(T2),10 min(T3)and after extubation(T4)of admin-istration were obviously lower than those in the control group(P<0.05).After surgery,the levels of IL-1βand CXCL8 in the serum of the two groups ob-viously increased(P<0.05),but the experimental group showed a obvious decrease compared to the control group(P<0.05);there was no significant dif-ference in the incidence of complications between the two groups(P>0.05).CONCLUSION:The com-bined anesthesia of remimazolam tosilate and remi-fentanil has an ideal effect and high clinical applica-tion value for elderly patients undergoing spinal surgery.
作者
董力
周枫
DONG Li;ZHOU Feng(Department of Anesthesia,Xiaoshan Hospital of Traditional Chinese Medicine/Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou 311200,Zhejiang,China)
出处
《中国临床药理学与治疗学》
CAS
CSCD
2023年第12期1372-1377,共6页
Chinese Journal of Clinical Pharmacology and Therapeutics
基金
中国红十字基金会医学赋能公益专项基金“医学赋能与人才培养计划”科研项目(202206151618000360310)。
