普罗波与雷米马佐拉姆对认知功能,血液动力学和氧化在一个肺通风的老年患者进行肺腔切除术期间的普罗波与雷米马佐拉姆:随机对照试验
Qijuan Kuang1, Nayin Zhong1, Changsheng Ye1
1Department of Anesthesiology and Operation, Medical Center of Anesthesia and Pain, The First Affiliated Hospital of Nanchang University, Jiangxi, China.
Journal of cardiothoracic and vascular anesthesia
|July 8, 2023
概括
雷米马佐拉姆麻醉剂改善了老年患者的认知功能和手术内血液动力学,与普罗波相比,他们接受了叶片切除术. 它还在单肺通风期间增强了氧化,减少了低血压风险.
科学领域:
- 麻醉学 麻醉学
- 心血管医学 心血管医学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 手术后认知功能障碍 (POCD) 是接受手术的老年患者的一个担忧.
- 在肺叶切除术期间,优化手术内血液动力学和氧化非常重要,特别是在单肺通风 (OLV) 时.
- 普罗波是一种常见的麻醉剂,但它对POCD和血液动力学的影响需要在特定患者群体中进一步研究.
研究的目的:
- 为了比较雷米马佐拉姆与普罗波福尔对经皮切除术的老年患者手术后认知功能的影响.
- 为了评估雷米马佐拉姆对手术内血动力学和氧化在OLV的带切除过程中的影响.
- 评估雷米马佐拉姆在这种手术环境中的安全性和有效性.
主要方法:
- 这是一项前性,双盲,随机对照性研究,涉及84名65岁以上的患者进行带切除术.
- 麻醉是诱导和维护的雷米马佐拉姆 (R组) 或普罗波 (P组).
- 在手术前和手术后7天使用神经心理测试来评估认知功能. 在整个手术过程中,血液动力学,氧化 (PaO2,OI,Qs/Qt) 和生物标志物 (S-100β,IL-6) 被监测.
主要成果:
- 在手术后7天的Remimazolam组在口头流利性测试,数字符号切换测试和听觉口头学习测试-Huashan中显示出明显更高的得分.
- 接受雷米扎洛拉姆治疗的患者表现出显著更高的缩血压和平均动脉压,低血压的发病率相比,与普罗波相比较低.
- 雷米马拉姆导致手术期间氧化率改善 (高PaO2和OI),OLV期间肺内转移率降低,以及术后S-100β水平降低.
结论:
- 雷米马佐拉姆可以减少短期的术后认知功能障碍在老年患者进行带切除术相比,与propofol.
- 雷米马佐拉姆在OLV期间提供了更好的手术内血动力学稳定性和更好的氧化.
- 雷米马佐拉姆似乎是一个潜在的优势麻醉剂的老年患者接受肺叶切除术.
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