Objective:To explore the half-effective dose(ED_(50))of remazolam toluenesulfonate combined with subthreshold amounts of esketamine for inhibiting cardiovascular response to tracheal intubation in elderly patients.Met...Objective:To explore the half-effective dose(ED_(50))of remazolam toluenesulfonate combined with subthreshold amounts of esketamine for inhibiting cardiovascular response to tracheal intubation in elderly patients.Method:We included 42 patients,aged 65-75,who required general anesthesia and single-lumen endotracheal intubation for elective surgery.The first patient was administered remazolam toluenesulfonate at a dose of 0.20 mg/kg.Once the patient lost consciousness,their alertness/sedation score(OAA/S score)was≤1,and their BIS score was≤60,and a subthreshold dose(0.3 mg/kg)of esketamine was given.The subsequent doses were adjusted using a sequential approach based on the cardiovascular response to tracheal intubation observed in the previous patient.The dose was modified in increments or decrements of 0.01 mg/kg.The ED_(50)and 95%CI of remazolam toluenesulfonate were calculated using the Dixon and Massey sequential distribution test method.Result:The inhibition of endotracheal intubation response was positively correlated with the dose of remazolam toluenesulfonate,and the depth of sedation could not be achieved when the amount was≤0.22 mg/kg.The ED_(50)of remazolam toluenesulfonate combined with a subthreshold dose of esketamine in inhibiting cardiovascular response to tracheal intubation in elderly patients was 0.30(0.28,0.33)mg/kg.There was no statistically significant difference in blood pressure between the induction of anesthesia and before the operation.Conclusion:When compounded with 0.3 mg/kg esketamine,the ED_(50)of Remazolam toluenesulfonate in inhibiting cardiovascular response to endotracheal intubation in elderly patients was 0.30 mg/kg(95%CI0.28-0.33 mg/kg).展开更多
目的研究单次亚麻醉剂量艾司氯胺酮对全身麻醉下结直肠癌根治术患者术后早期情绪反应及恢复情况的影响。方法采用回顾性分析,选取2022年10月至2023年4月南京大学医学院附属鼓楼医院收治的120例全身麻醉下结直肠癌根治术患者为观察对象,...目的研究单次亚麻醉剂量艾司氯胺酮对全身麻醉下结直肠癌根治术患者术后早期情绪反应及恢复情况的影响。方法采用回顾性分析,选取2022年10月至2023年4月南京大学医学院附属鼓楼医院收治的120例全身麻醉下结直肠癌根治术患者为观察对象,按照麻醉方式不同分为研究组(n=60)与对照组(n=60)。研究组全身麻醉诱导之前给予0.3 mg/kg体重艾司氯胺酮一次性静脉推注,对照组正常麻醉;两组患者全身麻醉诱导、手术过程中麻醉维持、手术完成之后静脉镇痛药物及方式一致。比较两组患者手术前后焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分与术后(24、48 h)恢复质量评分量表(QOR40)评分、术后(1、3、6、18、24 h)视觉模拟评分法(VAS)评分、术后(24、48 h)改良警觉/镇静评分(MOAA/S)量表评分、术后苏醒时间、术后首次排气时间、术后下床时间及术后不良反应发生率。结果术后48 h,研究组患者SAS、SDS评分均明显低于术前,差异均有统计学意义(P<0.05);对照组手术前后SAS、SDS评分比较,差异均无统计学意义(P>0.05);研究组术后48 h SAS、SDS评分分别为(44.21±4.58)、(41.26±5.09)分,均低于对照组[(52.84±5.69)、(51.03±6.48)分],差异均有统计学意义(P<0.05)。研究组患者术后24、48 h QOR40评分分别为(142.51±4.86)、(150.84±5.73)分,均高于对照组[(134.06±5.17)、(142.49±5.52)分],差异均有统计学意义(P<0.05)。研究组患者术后1、3、6、18、24 h VAS评分分别为(2.49±0.74)、(2.27±0.68)、(2.11±0.64)、(1.97±0.63)、(1.86±0.65)分,均低于对照组[(2.97±0.81)、(2.71±0.75)、(2.58±0.69)、(2.47±0.65)、(2.33±0.67)分],差异均有统计学意义(P<0.05)。研究组患者术后24、48 h MOAA/S评分分别为(141.42±14.51)、(150.28±14.86)分,均低于对照组[(133.19±13.18)、(142.22±13.47)分],差异均有统计学意义(P<0.05)。研究组患者术后首次排气、下床时间分别为(39.01±4.73)、(33.31±4.57)h,均明显短于对照组[(43.86±5.25)、(37.65±5.19)h],差异均有统计学意义(P<0.05);两组患者术后苏醒时间比较,差异无统计学意义(P>0.05)。两组患者术后总不良反应发生率比较,差异无统计学意义(P>0.05)。结论单次亚麻醉剂量艾司氯胺酮用于全身麻醉下结直肠癌根治术麻醉可有效缓解患者情绪反应,提升术后早期镇痛、镇静效果,缓解疼痛程度,提高术后恢复质量及速度,且不良反应少。展开更多
文摘Objective:To explore the half-effective dose(ED_(50))of remazolam toluenesulfonate combined with subthreshold amounts of esketamine for inhibiting cardiovascular response to tracheal intubation in elderly patients.Method:We included 42 patients,aged 65-75,who required general anesthesia and single-lumen endotracheal intubation for elective surgery.The first patient was administered remazolam toluenesulfonate at a dose of 0.20 mg/kg.Once the patient lost consciousness,their alertness/sedation score(OAA/S score)was≤1,and their BIS score was≤60,and a subthreshold dose(0.3 mg/kg)of esketamine was given.The subsequent doses were adjusted using a sequential approach based on the cardiovascular response to tracheal intubation observed in the previous patient.The dose was modified in increments or decrements of 0.01 mg/kg.The ED_(50)and 95%CI of remazolam toluenesulfonate were calculated using the Dixon and Massey sequential distribution test method.Result:The inhibition of endotracheal intubation response was positively correlated with the dose of remazolam toluenesulfonate,and the depth of sedation could not be achieved when the amount was≤0.22 mg/kg.The ED_(50)of remazolam toluenesulfonate combined with a subthreshold dose of esketamine in inhibiting cardiovascular response to tracheal intubation in elderly patients was 0.30(0.28,0.33)mg/kg.There was no statistically significant difference in blood pressure between the induction of anesthesia and before the operation.Conclusion:When compounded with 0.3 mg/kg esketamine,the ED_(50)of Remazolam toluenesulfonate in inhibiting cardiovascular response to endotracheal intubation in elderly patients was 0.30 mg/kg(95%CI0.28-0.33 mg/kg).
文摘目的研究单次亚麻醉剂量艾司氯胺酮对全身麻醉下结直肠癌根治术患者术后早期情绪反应及恢复情况的影响。方法采用回顾性分析,选取2022年10月至2023年4月南京大学医学院附属鼓楼医院收治的120例全身麻醉下结直肠癌根治术患者为观察对象,按照麻醉方式不同分为研究组(n=60)与对照组(n=60)。研究组全身麻醉诱导之前给予0.3 mg/kg体重艾司氯胺酮一次性静脉推注,对照组正常麻醉;两组患者全身麻醉诱导、手术过程中麻醉维持、手术完成之后静脉镇痛药物及方式一致。比较两组患者手术前后焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分与术后(24、48 h)恢复质量评分量表(QOR40)评分、术后(1、3、6、18、24 h)视觉模拟评分法(VAS)评分、术后(24、48 h)改良警觉/镇静评分(MOAA/S)量表评分、术后苏醒时间、术后首次排气时间、术后下床时间及术后不良反应发生率。结果术后48 h,研究组患者SAS、SDS评分均明显低于术前,差异均有统计学意义(P<0.05);对照组手术前后SAS、SDS评分比较,差异均无统计学意义(P>0.05);研究组术后48 h SAS、SDS评分分别为(44.21±4.58)、(41.26±5.09)分,均低于对照组[(52.84±5.69)、(51.03±6.48)分],差异均有统计学意义(P<0.05)。研究组患者术后24、48 h QOR40评分分别为(142.51±4.86)、(150.84±5.73)分,均高于对照组[(134.06±5.17)、(142.49±5.52)分],差异均有统计学意义(P<0.05)。研究组患者术后1、3、6、18、24 h VAS评分分别为(2.49±0.74)、(2.27±0.68)、(2.11±0.64)、(1.97±0.63)、(1.86±0.65)分,均低于对照组[(2.97±0.81)、(2.71±0.75)、(2.58±0.69)、(2.47±0.65)、(2.33±0.67)分],差异均有统计学意义(P<0.05)。研究组患者术后24、48 h MOAA/S评分分别为(141.42±14.51)、(150.28±14.86)分,均低于对照组[(133.19±13.18)、(142.22±13.47)分],差异均有统计学意义(P<0.05)。研究组患者术后首次排气、下床时间分别为(39.01±4.73)、(33.31±4.57)h,均明显短于对照组[(43.86±5.25)、(37.65±5.19)h],差异均有统计学意义(P<0.05);两组患者术后苏醒时间比较,差异无统计学意义(P>0.05)。两组患者术后总不良反应发生率比较,差异无统计学意义(P>0.05)。结论单次亚麻醉剂量艾司氯胺酮用于全身麻醉下结直肠癌根治术麻醉可有效缓解患者情绪反应,提升术后早期镇痛、镇静效果,缓解疼痛程度,提高术后恢复质量及速度,且不良反应少。
