Abstract:【Objective】To explore the sedative effect and hemodynamic impact of remimazolam toluenesulfonate on anesthesia induction in elderly hypertensive patients.【Methods】A total of 100 elderly hypertensive patients who underwent elective general anesthesia and required tracheal intubation at the Changsha Central Hospital from October 2021 to October 2022 were randomly divided into an observation group (using remimazolam anesthesia) and a control group (using etomidate anesthesia) using a random number table method,with 50 patients in each group. The time from the onset of wakefulness to BIS values less than 60 was recorded,and the changes in mean arterial pressure (MAP),heart rate (HR),and BIS values were recorded at four time points: before induction (T0),after induction to BIS<60 (T1),1 minute after intubation (T2),and 5 minutes after intubation (T3). Blood samples were collected at these four time points to compare the serum levels of norepinephrine (NE) between the two groups of patients. The incidence of adverse events such as muscle spasms,tachycardia,bradycardia,hypertension,and hypotension during anesthesia induction was compared between two groups.【Results】The HR at T1 and T2 in the observation group was higher than that at T0,and the MAP at T0 and T2 was higher than that at T1,with a statistically significant difference (P<0.05); The MAP and HR of the control group at T0 and T2 were higher than those of T1,with statistically significant differences (P<0.05); The MAP and HR of the observation group at T1 were higher than those of the control group,and the difference was statistically significant (P<0.05). The serum NE levels at T0 and T2 in the observation group and the control group were higher than those at T1,and the difference was statistically significant (P<0.05); The serum NE levels in the observation group at T2 and T3 were lower than those in the control group,with a statistically significant difference (P<0.05). The onset time of anesthesia induction in the observation group was longer than that in the ET group,and the incidence of muscle fibrillation,hypotension,and bradycardia was lower than that in the control group,with a statistically significant difference (P<0.05).【Conclusion】The use of remimazolam during the induction period of general anesthesia in elderly hypertensive patients can stabilize hemodynamic indicators,and the incidence of adverse reactions such as muscle spasms,hypotension,and bradycardia during the induction period is relatively low.
武丽辉, 刘松华. 甲苯磺酸瑞马唑仑对老年高血压患者全麻诱导期间的血流动力学的影响[J]. 医学临床研究, 2023, 40(8): 1139-1142.
WU Li-hui, LIU Song-hua. Effect of Remimazolam on Hemodynamics during General Anesthesia Induction in Elderly Hypertensive Patients. JOURNAL OF CLINICAL RESEARCH, 2023, 40(8): 1139-1142.
[1] 高丽红,杨保仲,刘思敏,等. 右美托咪定和利多卡因对高血压病人全身麻醉苏醒期拔管反应的影响[J].中西医结合心脑血管病杂志,2021,19(14):2417-2420. [2] 刘会凤,陶志国,罗宏丽,等.右美托咪定对气管插管全麻老年高血压病人血流动力学的影响[J].蚌埠医学院学报,2019,44(7):923-926. [3] QIU Y,GU W,ZHAO M,et al.The hemodynamic stability of remimazolam compared with propofol in patients undergoing endoscopic submucosal dissection: a randomized trial[J].Front Med (Lausanne),2022,9:938940. [4] GUO J,QIAN Y,ZHANG X,et al. Remimazolam tosilate compared with propofol for gastrointestinal endoscopy in elderly patients: a prospective,randomized and controlled study[J].BMC Anesthesiol,2022,22(1):180. [5] 苏冠男.全身麻醉联合硬膜外麻醉对老年高血压腹腔镜胆囊切除术患者麻醉效果及心率变异性的影响[J].临床研究,2020,28(1):84-85. [6] 赵晓咏,夏瑞,刘香玉,等. 瑞马唑仑用于腹部手术患者全麻诱导与维持的效果[J].中华麻醉学杂志,2021,41(7):823-826. [7] 邓彩英,覃兆军,陈小波,等.丙泊酚联合依托咪酯对全麻诱导气管插管期间血流动力学的影响[J].广东医学,2012,33(3):401-403. [8] KIM K M. Remimazolam: pharmacological characteristics and clinical applications in anesthesiology[J].Anesth Pain Med (Seoul),2022,17(1): 1-11. [9] 安璐,刘颖,崔秀花,等.氟马西尼拮抗瑞马唑仑全身麻醉术后残余镇静作用的临床观察[J].中国医药,2022,17(12):1846. [10] 窦豆,栗亚茹,王璐,等.新型镇静药物瑞马唑仑的研究进展[J].中国医药2023,18(3):453-457. [11] ANTONIK L J,GOLDWATER D R,KILPATRICK G J,et al.A placebo-and mi-dazolam-controlled phase Ⅰ single ascending-dose study evaluating the safety,pharmacokinetics,and pharmacodynamics of remimazolam ( CNS 7056):part Ⅰ. Safety,efficacy,and basic pharmacokinetics[J].Anesth Analg,2012,115(2):274-283. [12] 张璇,李亭仪,郭志佳,等.甲苯磺酸瑞马唑仑在子宫病损电切术麻醉中的应用研究[J].中南药学,2022,20(12):2944-2949.