瑞马唑仑与丙泊酚在中老年腹腔镜子宫切除患者诱导与维持阶段的麻醉效果对比

Comparison of Anesthetic Effect of Remimazolam and Propofol in Induction and Maintenance Stage in Middle-aged and Elderly Patients Undergoing Laparoscopic Hysterectomy

目的:比较瑞马唑仑与丙泊酚在中老年腹腔镜子宫切除患者中诱导与维持阶段的麻醉效果。方法:选取2022年4月—2023年4月麻城市人民医院收治的中老年腹腔镜子宫切除患者80例为研究对象,以随机数表法分为对照组与观察组,各40例。对照组采用丙泊酚、舒芬太尼、罗库溴铵行麻醉诱导,术中采用瑞芬太尼、丙泊酚行麻醉维持,观察组采用瑞马唑仑、舒芬太尼、罗库溴铵行麻醉诱导,术中采用瑞芬太尼、瑞马唑仑行麻醉维持。比较两组血流动力学指标、术后恢复时间、认知功能及不良反应发生情况。结果:麻醉诱导时,两组平均动脉压(MAP)、心率(HR)比较,差异无统计学意义(P>0.05);脑电双频指数<60时,观察组MAP高于对照组,HR低于对照组,差异有统计学意义(P<0.05);插管后,观察组MAP、HR低于对照组,差异有统计学意义(P<0.05)。观察组睁眼、拔管及监测治疗室停留时间均短于对照组,差异有统计学意义(P=0.001)。术后24、72 h,两组简易精神状态评价量表评分均降低,观察组高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P=0.034)。结论:相较于丙泊酚,中老年腹腔镜子宫切除患者术中采用瑞马唑仑行麻醉诱导、维持,更利于维持术中血流动力学的稳定,且对认知功能的影响较小,患者术后恢复时间更短,不良反应发生率更低。

Objective:To compare the anesthetic effects of remimazolam and propofol in induction and maintenance stage in middle-aged and elderly patients undergoing laparoscopic hysterectomy.Methods:A total of eighty middle-aged and elderly patients with laparoscopic hysterectomy admitted to Macheng People's Hospital from April 2022 to April 2023 were selected as the study objects,and were divided into control group and observation group by random number table method,with forty cases in each group.The control group received anesthesia induction by propofol,sufentanil and rocuronium,and received anesthesia maintenance by remifentanil and propofol during the operation.The observation group received anesthesia induction by remifentanil,sufentanil and rocuronium,and received anesthesia maintenance by remifentanil and remimazolam during the operation.Hemodynamic indexes,postoperative recovery time,cognitive function and adverse reactions were compared between the two groups.Results:There was no significant difference in mean arterial pressure(MAP)and heart rate(HR)between the two groups during anesthesia induction(P>0.05);When bi frequency index<60,MAP and HR of observation group were higher than control group,and the difference was statistically significant(P<0.05);After intubation,MAP and HR in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05);The stay time of eye opening,extubation and monitoring treatment room in the observation group was shorter than that in the control group,and the difference was statistically significant(P=0.001);24 and 72 h after operation,the scores of simple mental state assessment scale score in the two groups were decreased,and the observation group was higher than the control group,the difference was statistically significant(P<0.05);The incidence of adverse reactions in observation group was lower than that in control group,and the difference was statistically significant(P=0.034).Conclusion:Compared with propofol,the use of remimazolam for anesthesia induction and maintenance in middle-aged and elderly laparoscopic hysterectomy patients is more conducive to maintaining the stability of intraoperative hemodynamics,and has less impact on cognitive function,and the postoperative recovery time of patients is shorter and the incidence of adverse reactions is lower.