瑞马唑仑复合小剂量丙泊酚在腹腔镜胆囊切除术中的应用

Application of Remimazolam Combined with Low Dose Propofol in Laparoscopic Cholecystectomy

目的:研究瑞马唑仑复合小剂量丙泊酚对行腹腔镜胆囊切除术(LC)患者生命体征、认知功能的影响。方法:选取福建医科大学附属闽东医院2021年6月—2022年3月收治的60例行LC的患者作为研究对象,按照随机数表法将其分为对照组和观察组,各30例。对照组接受丙泊酚+常规麻醉诱导,观察组接受瑞马唑仑+小剂量丙泊酚麻醉诱导,两组均观察至出院。比较两组麻醉恢复指标,于诱导前(T_(0))、气管插管前即刻(T_(1))、气管插管后1 min(T_(2))和3 min(T_(3))统计比较两组的平均动脉压(MAP)、心率(HR),于术前、术后24 h及72 h统计比较两组的简易精神状态评价量表(MMSE)评分,比较两组麻醉诱导时间、低血压及心动过缓发生率。结果:观察组睁眼时间、拔管时间及PACU停留时间均短于对照组,差异有统计学意义(P<0.05)。T_(1)~T_(3)时,两组的MAP、HR水平均低于T_(0)时,但观察组的MAP、HR水平明显高于对照组,差异有统计学意义(P<0.05)。术后24~72 h,两组的MMSE评分低于术前,但观察组高于对照组,差异有统计学意义(P<0.05)。观察组的麻醉诱导时间长于对照组,低血压发生率、心动过缓发生率低于对照组,差异有统计学意义(P<0.05)。结论:瑞马唑仑复合小剂量丙泊酚能够减少行LC患者生命体征波动,促进认知功能恢复,缩短麻醉恢复时间,减少不良反应发生率,安全性较好。

Objective:To study the effects of Remimazolam combined with low dose Propofol on vital signs and cognitive function in patients undergoing laparoscopic cholecystectomy(LC).Method:A total of 60 patients with LC admitted to Mindong Hospital Affiliated to Fujian Medical University from June 2021 to March 2022 were selected as the study subjects.They were divided into control group and observation group according to the random number table method,with 30 patients in each group.The control group received Propofol+conventional anesthesia induction,while the observation group received Remimazolam+low dose Propofol anesthesia induction.Both groups were observed until discharge.The recovery indicators of anesthesia between two groups were compared.The mean arterial pressure(MAP)and heart rate(HR)of the two groups before induction(T_(0)),immediately before tracheal intubation(T_(1)),and 1 minute(T_(2))and 3 minutes(T_(3))after tracheal intubation were compared.The mini-mental state examination(MMSE)scores of the two groups before surgery,24 h and 72 h after surgery were compared,and compared the induction time,hypotension,and incidence of bradycardia between the two groups.Result:The had shorter eye opening time,extubation time,and PACU retention time of the observation group were shorter than those of the control group,the differences were statistically significant(P<0.05).At T_(1)-T_(3),the levels of MAP and HR in both groups were lower than those at T_(0),but the levels of MAP and HR in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).At 24 h and 72 h after surgery,the MMSE scores of the two groups were lower than before surgery,but the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The anesthesia induction time of the observation group was longer than that of the control group,and the incidence of hypotension and bradycardia were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Remimazolam combined with low dose Propofol can reduce the fluctuation of vital signs,promote the recovery of cognitive function,shorten the recovery time of anesthesia,reduce the incidence of adverse reactions,and has good safety.