在接受重大腹部手术的老年患者中,雷米马佐拉姆对术后妄想的作用:随机对照试验
Keyao Zhang1,2, Leiyuan Zhong3, Bin Shang1,2
1Department of Anesthesiology, The First People's Hospital of Lianyungang, Jiangsu, China.
International journal of surgery (London, England)
|November 11, 2025
概括
在老年人中,雷米马佐拉姆麻醉剂并没有增加术后狂妄症 (POD) 的风险,相比于propofol. 需要进一步的研究,但雷米马佐拉姆在特殊人群中对麻醉有希望.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 外科手术的结果
背景情况:
- 老年患者面临高风险的术后妄 (POD).
- 一般麻醉的选择可能会影响术后的认知功能.
- 雷米马佐拉姆是一种新型的二甲,具有快速发作和最小的器官代谢.
研究的目的:
- 为了比较基于propofol和基于remimazolam的全身麻醉之间的POD发病率.
- 为了评估雷米马佐拉姆与普罗波福尔对接受重大腹部手术的老年人认知结果的影响.
主要方法:
- 370名接受重大腹部手术 (>2小时) 的老年人 (65-89岁) 被随机分类.
- 麻醉是诱导和维持使用propofol或remimazolam.
- 痴呆症在术后5天内使用混乱评估 (CAM) 或CAM-ICU尺度进行评估.
主要成果:
- 雷米马佐拉姆和普罗波组之间的POD发病率没有显著差异 (17.1%对比19.7%).
- 低血压在雷米马佐拉姆组发生的频率较低 (P=0.009).
- 年龄≥75岁是与麻醉干预相互作用的重要因素 (P<0.001).
结论:
- 在老年外科手术患者中,雷米马佐拉姆似乎不会增加POD的风险,而与普罗波相比.
- 需要进行更大规模的研究来证实这些发现.
- 雷米马佐拉姆的安全性概况表明,它有可能成为特定患者群体的替代麻醉策略.
相关概念视频
Sedatives and Hypnotics Drugs: Miscellaneous Agents
490
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
490
REM Sleep Behavior Disorder
1.3K
REM Sleep Behavior Disorder (RBD) is a sleep disorder characterized by the absence of muscle paralysis that normally occurs during the REM phase of sleep. This absence allows individuals to physically act out their dreams, which are often vivid and disturbing. Common behaviors exhibited during episodes include kicking, punching, and yelling. These actions can be dangerous, potentially leading to injuries for the person with RBD or their bed partner.
RBD is significantly associated with...
RBD is significantly associated with...
1.3K
Stages of General Anesthesia
1.4K
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
1.4K
General Anesthesia: Overview
556
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
556
Parenteral Anesthetics: Overview
565
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
565
Sedatives and Hypnotics Drugs: Benzodiazepines
744
Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
744


