苯磺酸瑞马唑仑在心脏重症患者术后的镇静效果

Sedative Effect of Remazolam Besylate in Severe Patients After Cardiac Surgery

目的探讨苯磺酸瑞马唑仑对心脏重症患者术后的镇静效果及对认知功能、血流动力学的影响。方法采用前瞻性随机对照研究,选取2022年1—12月医院收治的80例心脏外科术后入住重症监护室患者,按照就诊先后顺序,采用单双号法分组,各40例。A组接受苯磺酸瑞马唑仑镇静药;B组接受美右托咪定镇静药。比较两组镇静效果、术后恢复情况、血流动力学[混合/中心静脉血氧饱和度(SvO_(2)/ScvO_(2))、平均动脉压(MAP)、心率(HR)]、认知功能、不良反应。结果A组达到目标镇静时间、镇静深度满意时间、停药后恢复时间短于B组(P<0.05)。A组第1次脱机时间短于B组(P<0.05),机械通气时间、ICU停留时间短于B组,但组间差异无统计学意义(P>0.05)。T1~2时,A组HR、MAP高于B组,SvO_(2)/ScvO_(2)低于B组,但组间差异无统计学意义(P>0.05)。停药后2、24 h,两组MMSE评分均高于镇静前,但组间差异无统计学意义(P>0.05);A组认知功能障碍发生率低于B组(P<0.05)。围手术期,两组不良反应发生率差异无统计学意义(P>0.05)。结论相较于右美托咪定,苯磺酸瑞马唑仑更能减轻心脏术后重症患者认知损害,促进术后恢复,提供满意镇静效果。

Objective To investigate the sedative effect of remazolam benzoate on cognitive function and hemodynamics in patients with severe cardiac surgery.Methods A prospective randomized controlled study was conducted to select 80 postoperative cardiac surgery patients admitted to the intensive care unit in hospitals from January to December 2022.According to the order of visits,the patients were divided into groups using a single and double number method,with 40 patients in each group.Group A received remimazolam besylate sedative,group B received metomidine sedatives.Sedation effect,postoperative recovery,hemodynamics[mixed/central venous oxygen saturation(SvO_(2)/ScvO_(2)),mean arterial pressure(MAP),heart rate(HR)],cognitive function and adverse reactions were compared between the two groups.Results The target sedation time,satisfaction time with sedation depth,and recovery time after discontinuation of medication in group A were shorter than those in group B(P<0.05).The first offline time in group A was shorter than that in group B(P<0.05),and the mechanical ventilation time and ICU stay time were shorter than those in group B,but there was no statistically significant difference between the groups(P>0.05).At T1-2,HR and MAP in group A were higher than those in group B,while SvO_(2)/ScvO_(2) was lower than that in group B,but there was no statistically difference between the groups(P>0.05).At 2 and 24 hours after discontinuation,the MMSE scores of both groups were higher than before sedation,but there was no statistically difference between the groups(P>0.05).The incidence of cognitive impairment in group A was lower than that in group B(P<0.05).During the perioperative period,there was no statistically difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with dexmedetomidine,remazolam besylate can reduce cognitive impairment,promote postoperative recovery and provide satisfactory sedative effect in patients with severe cardiac surgery.