瑞马唑仑对老年NSCLC根治性手术患者手术应激反应、术后苏醒期质量及拔管时间的影响

doi:10.3969/j.issn.1671-7171.2024.03.012

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1141 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要【目的】探讨瑞马唑仑对老年非小细胞肺癌(NSCLC)根治性手术患者应激反应、术后苏醒期质量及拔管时间的影响。【方法】在新乡医学院第一附属医院行NSCLC根治性手术的80例患者随机分为两组,每组40例,对照组使用丙泊酚进行麻醉诱导和维持,观察组使用瑞马唑仑进行麻醉诱导和维持。比较两组手术前后肾上腺皮质激素(ACTH)和一氧化氮(NO)水平;比较两组患者麻醉诱导前(T₁)、插管1 min内(T₂)、手术开始后30 min(T₃)、手术完成时(T₄)、拔管10 min后(T₅)的心率(HR)和平均动脉压(MAP);比较两组患者术后苏醒期恢复质量及呛咳发生情况。【结果】与术前相比,两组患者术后ACTH水平明显升高,NO水平显著降低(P<0.05),但组间比较差异无统计学意义(P>0.05)。两组T₂、T₃时较HR及MAP水平均T₁时明显降低(P<0.05),观察组T₂时HR及MAP水平高于对照组(P<0.05)。两组患者苏醒期脑电双频谱指数(BIS)、术后视觉模拟评分法(VAS)评分、躁动情况比较,差异无统计学意义(P>0.05)。观察组患者的睁眼时间、拔管时间及患者在麻醉后监测治疗室(PACU)停留时间均短于对照组(P<0.05)。观察组呛咳发生率低于对照组(P<0.05)。【结论】在老年患者行NSCLC根治性手术时使用瑞马唑仑麻醉诱导,有利于维持血流动力学稳定,提高患者的苏醒期质量,降低拔管呛咳的发生率。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	贾志杰
	张晓冉
	段文姣

关键词 ：癌,非小细胞肺/外科学, 瑞马唑仑, 应激,生理学, 麻醉恢复期

Abstract：【Objective】To explore the effects of remimazolam on stress response, postoperative recovery quality, and extubation in elderly patients undergoing radical surgery for non-small cell lung cancer(NSCLC).【Methods】Eighty patients undergoing radical NSCLC surgery in The First Affiliated Hospital of Xinxiang Medical University were randomly divided into two groups, with 40 patients in each group. The control group received propofol, while the observation group was induced and maintained with remimazolam anesthesia. Levels of adrenocorticotropic hormone(ACTH) and nitric oxide(NO) were compared pre-surgery and post-surgery between the two groups. Additionally, heart rate(HR) and mean arterial pressure(MAP) were compared at different time points: before anesthesia induction(T₁), within 1 minute of intubation(T₂), 30 minutes after surgery started(T₃), at the end of surgery(T₄), and 10 minutes after extubation(T₅). Postoperative recovery quality and the incidence of coughing were also compared between the groups. 【Results】 Compared to pre-surgery levels, both groups showed a significant increase in ACTH level and a decrease in NO level(P<0.05), but there was no significant difference between the groups(P>0.05). Both groups had significantly lower HR and MAP at T₂ and T₃ compared to T₁(P<0.05). HR and MAP levels at T₂ were higher in the observation group compared to the control group(P<0.05). There was no significant difference between the two groups in terms of postoperative recovery quality measured by bispectral index(BIS), postoperative visual analogue scale(VAS) scores, and agitation(P>0.05). The observation group had shorter eye-opening time, extubation time, and duration of stay in the post-anesthesia care unit(PACU) compared to the control group(P<0.05). The incidence of coughing was lower in the observation group(P<0.05). 【Conclusion】 The use of remimazolam for anesthesia induction in elderly patients undergoing radical NSCLC surgery can maintain hemodynamic stability, improve the quality of recovery period, and reduce the incidence of coughing during extubation.

Key words： Carcinoma, Non-Small-Cell Lung/SU Remimazolam Stress, Physiological Anesthesia Recovery Period

收稿日期: 2023-08-11

中图分类号:

R734.2

通讯作者: *E-mail:jiazhijie80@126.com

引用本文:

贾志杰, 张晓冉, 段文姣. 瑞马唑仑对老年NSCLC根治性手术患者手术应激反应、术后苏醒期质量及拔管时间的影响[J]. 医学临床研究, 2024, 41(3): 364-367.
JIA Zhijie, ZHANG Xiaoran, DUAN Wenjiao. The Effect of Remimazolam on Surgical Stress Response, Quality of Postoperative Recovery, and Extubation in Elderly Patients Undergoing Radical Surgery for NSCLC. JOURNAL OF CLINICAL RESEARCH, 2024, 41(3): 364-367.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.03.012 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I3/364

[1] MITHOOWANI H, FEBBRARO M. Non-Small-Cell Lung Cancer in 2022: A review for general practitioners in oncology[J].Curr Oncol,2022,29(3):1828-1839.
[2] MIMAE T, OKADA M. Are segmentectomy and lobectomy comparable in terms of curative intent for early stage non-small cell lung cancer?[J].Gen Thorac Card Surg,2020, 68(7): 703-706.
[3] YU L S, LEI Y Q, LIU J F, et al. A comparison between selective lobar bronchial blockade and main bronchial blockade in pediatric thoracoscopic surgery: a retrospective cohort study[J].J Card Vasc Anesth,2022, 36(2): 518-523.
[4] LEE A, SHIRLEY M. Remimazolam: a review in procedural sedation[J].Drugs,2021, 81(10): 1193-1201.
[5] ALEXANDER M, KIM S Y, CHENG H. Update 2020: management of non-small cell lung cancer[J].Lung,2020, 198(6): 897-907.
[6] RUIZ-CORDERO R, DEVINE W P. Targeted therapy and checkpoint immunotherapy in lung cancer[J].Surg Pathol Clin,2020,13(1):17-33.
[7] 刘琼,熊娟. 右美托咪啶复合丙泊酚静脉泵注对原发性肝癌患者围手术期应激反应、免疫功能的影响[J].山东医药,2021,61(6):31-35.
[8] 李富贵, 王皓, 王云, 等. 瑞马唑仑复合阿芬太尼在无痛胃肠镜检查中的应用[J].临床麻醉学杂志, 2022,38(7):767-769.
[9] CHUNGSAMARNYART Y, PAIRART J, MUNJUPONG S. Comparison of the effects of intravenous propofol and propofol with low-dose ketamine on preventing postextubation cough and laryngospasm among patients awakening from general anaesthesia: A prospective randomised clinical trial[J].J Perioper Pract,2022, 32(3): 53-58.
[10] HE L X, SHAO K, MA J, et al. Is dezocine effective and safe in preventing opioids-induced cough during general anaesthesia induction? A protocol for systematic review and meta-analysis[J].BMJ Open,2020,10(6): e035691.
[11] 贾真, 任丽霞, 范叶铁, 等 . 甲苯磺酸瑞马唑仑用于纤维支气管镜检查中深度镇静的有效剂量观察[J].中华医学杂志, 2021,101(11):813-816.
[12] NOUSHAD S, AHMED S, ANSARI B, et al. Physiological biomarkers of chronic stress: a systematic review[J].Int J Health Sci(Qassim),2021,15(5):46-59.