术中瑞马唑仑和丙泊酚维持麻醉对老年全麻手术患者血流动力学和苏醒质量的影响

Effects of intraoperative maintenance anesthesia with remimazolam and propofol on hemodynamics and recovery quality in elderly patients undergoing surgery under general anesthesia

目的:探讨术中瑞马唑仑和丙泊酚维持麻醉对老年全麻手术患者血流动力学和苏醒质量的影响。方法:将本院2020年3月至2023年5月进行全麻手术的70例患者作为研究对象,按随机数表法分为对照组和观察组,每组35例。对照组接受丙泊酚术中维持麻醉,观察组接受瑞马唑仑术中维持麻醉。比较两组患者的血流动力学、苏醒质量和不良反应发生率。结果:观察组不同时间点的平均动脉压(Mean arterial pressure,MAP)、心率(Heart rate,HR)差异无统计学意义(P>0.05),仅插管1 min后(T2)的血氧饱和度(Oxygen saturation,SPO2)低于麻醉诱导前(T0)(P<0.05);对照组不同时间点的MAP、HR差异均有统计学意义(P<0.05);组间比较显示观察组T1、T2时点的MAP及T1时点的HR均显著高于对照组,T2时点的HR显著低于对照组(P<0.05);观察组术后拔管时间、呼之睁眼时间、自主呼吸时间均短于对照组(P<0.05);观察组术后不良反应发生率低于对照组(P<0.05)。结论:与丙泊酚相比,术中应用瑞马唑仑能够稳定老年患者术中血流动力学指标,提升术后苏醒质量,引发的不良反应少,安全性高。

Objective:To investigate the effects of maintenance anesthesia with remimazolam and propofol on hemodynamics and recovery quality in elderly patients undergoing surgery under general anesthesia.Methods:A total of 70 patients who underwent surgery under general anesthesia from March 2020 to May 2023 in our hospital were selected as the study subjects.They were divided into a control group and an observation group using the random number table method,with 35 cases in each group.The control group received intraoperative maintenance anesthesia with propofol while the observation group received intraoperative maintenance anesthesia with remimazolam.Hemodynamics,awakening quality,and the incidence rates of adverse reactions were compared between the two groups.Results:There was no statistically significant difference in mean arterial pressure(MAP)or heart rate(HR)of the observation group at different time points(P>0.05).Only oxygen saturation(SPO2)at 1 minutes after intubation(T2)was lower than that before anesthesia induction(T0)(P<0.05).MAP and HR of the control group showed statistically significant differences at different time points(P<0.05).Comparison between groups found that MAP at T1 and T2 and HR at T1 were significantly higher in the observation group than in the control group,while HR at T2 was significantly lower than the control group(P<0.05).Postoperative extubation time,eye opening time at request and spontaneous breathing time of the observation group were shorter than those of the control group(P<0.05).The incidence of postoperative adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:Compared with propofol,intraoperative use of remimazolam can stabilize hemodynamic indicators in elderly patients and improve postoperative recovery quality,with fewer adverse reactions and higher safety.