苯磺酸瑞马唑仑与丙泊酚全凭静脉麻醉对甲状腺手术患者血流动力学苏醒质量的影响

doi:10.3969/j.issn.1006-6233.2025.08.029

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1164 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的:对探讨苯磺酸瑞马唑仑与丙泊酚全凭静脉麻醉对甲状腺手术患者血流动力学、苏醒质量的影响。方法:用随机数字表法将138例行甲状腺手术患者分为对照组(丙泊酚全凭静脉全麻)和观察组(苯磺酸瑞马唑仑全凭静脉全麻),各69例。对比两组患者不同时刻时的血流动力学指标水平,对比两组患者手术情况与麻醉药物用量,拔管5min、30min、60min时镇静评分(RSS);并记录术后不良反应发生情况。结果:不同时间的心率(HR)、平均动脉压(MAP)差异均有统计学意义(F_时间=1.142、2.092,P<0.05),观察组与对照组MAP、HR差异有统计学意义(F_组间=33.701、21.421,P<0.05),观察组与对照组MAP、HR水平变化趋势有差异(F_交互=1.661、1.030,P<0.05)。观察组起效时间、插管时间均短于对照组(P<0.05);观察组瑞芬太尼用量、镇静剂用量均低于对照组(P<0.05);与对照组比,观察组自主呼吸恢复时间、睁眼的时间及定向力恢复时间均较短(P<0.05)。苏醒后不同时间RSS评分差异均有统计学意义(F_时间=16.191,P<0.05),观察组与对照组RSS评分差异有统计学意义(F_组间=38.042,P<0.05),观察组与对照组RSS评分变化趋势差异均有统计学意义(F_交互=7.230,P<0.05)。观察组麻醉期做梦例数多于对照组(P<0.05),两组均未出现烦躁谵妄,两组恶心呕吐不良反应发生率差异无统计学意义(P>0.05)。结论:与丙泊酚全凭静脉全麻相比,苯磺酸瑞马唑仑全麻在甲状腺手术中的应用效果较好,可促进患者麻醉后自主呼吸,减轻躁动,维持血流动力学稳定。

	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

关键词 ：苯磺酸瑞马唑仑, 丙泊酚, 全凭静脉麻醉, 甲状腺, 血流动力学, 苏醒质量

Abstract：Objective: To investigate the influence of total intravenous anesthesia with remimazolam besylate and propofol on hemodynamics and recovery quality in patients undergoing thyroid surgery. Methods: A total of 138 patients undergoing thyroid surgery were classified into control group (n=69, propofol total intravenous anesthesia) and observation group (n=69, remimazolam besylate total intravenous anesthesia) by adopting the random number table method. The hemodynamic indicators at different time points and surgical conditions and anesthetic dosage, and sedation score (RSS) at 5min, 30 min and 60 min after extubation were compared between groups, and the postoperative adverse reactions were recorded. Results: The heart rate (HR) and mean arterial pressure (MAP) were statistically different before tracheal intubation (T1) and at 1 min after tracheal intubation (T2), the starting of surgery (T3), 30 min after the starting of surgery (T4) and the time of postoperative recovery (T5) (F_time-point=1.142, 2.092, P<0.05). Compared with the control group, the observation group had higher MAP and HR (F_{between group}=33.701, 21.421, P<0.05), and the change trends of MAP and HR were different between groups (F_interaction=1.661, 1.030, P<0.05). The onset time and intubation time were shorter in the observation group (P<0.05). The remifentanil dosage and sedative dosage in the observation group were less (P<0.05). Compared with the control group, the recovery time of spontaneous breathing, eye opening time and orientation recovery time were shorter in the observation group (P<0.05). There was a statistical significance in RSS score at 5min and 30 min after recovery (F_time-point=16.191, P<0.05). The observation group had lower RSS score than the control group (F_{between group}= 38.042, P<0.05). There was a statistical difference in the change trend of RSS score between the observation group and the control group (F_interaction=7.230, P<0.05). The number of dreaming cases in the observation group during anesthesia was more than that in the control group (P<0.05), and no dysphoria and delirium occurred in both groups, and there was no obvious difference in incidence rate of nausea and vomiting between both groups (P>0.05). Conclusion: Remimazolam besylate general anesthesia has a better application effect during thyroid surgery compared to propofol total intravenous anesthesia, and it can better promote the spontaneous breathing after anesthesia, relieve the agitation, and maintain the hemodynamic stabil

Key words： Remazolam besylate Propofol Total intravenous anesthesia Thyroid Hemodynamics Recovery quality

基金资助:安徽省高等学校科学研究项目,(编号:2023AH051993)

通讯作者: 石军

引用本文:

王影, 陶静, 李菊, 王伟, 石军. 苯磺酸瑞马唑仑与丙泊酚全凭静脉麻醉对甲状腺手术患者血流动力学苏醒质量的影响[J]. 河北医学, 2025, 31(8): 1392-1396.
WANG Ying, et al. Influences of Total Intravenous Anesthesia with Remimazolam Besylate and Propofol on Hemodynamics and Recovery Quality in Patients with Thyroid Surgery. HeBei Med, 2025, 31(8): 1392-1396.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.08.029 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I8/1392

[1] 张庆军,李龙来,邱耿诚,等.腔镜技术在甲状腺手术中的应用进展[J].国际耳鼻咽喉头颈外科杂志,2022,46(4):227-231.
[2] Xu C,Wu Z,Yin A,et al.Hypercapnia and severe hyperkalemia following robot-assisted endoscopic thyroid surgery:a case report[J].Asian journal of surgery,2023,46(7):2838-2839.
[3] Jin Y,Zhou X,Chen X,et al.Internal branch of superior laryngeal nerve block by dexamethasone alleviates sore throat after thyroidectomy:a randomized controlledtrial[J].European Archives of Oto-Rhino-Laryngology,2022,279(12):5877-5884.
[4] 陈征,汪燕,韩钧德,等.超声引导下双侧颈浅丛阻滞对甲状腺术后咽喉疼痛的影响:一项前瞻性随机对照试验[J].同济大学学报(医学版),2023,44(6):872-876.
[5] 赵颖颖,李锋.瑞马唑仑与丙泊酚用于无痛胃肠镜检查临床比较[J].国外医学:麻醉学与复苏分册,2021,42(9):924-927.
[6] 谢柯祺,何玲,代艳,等.瑞马唑仑对甲状腺相关眼病的眶壁减压术病人术后谵妄,应激反应的影响[J].临床外科杂志,2022,30(6):548-551.
[7] 杨成迪,徐海龙,李健,等.瑞马唑仑与丙泊酚全麻诱导对颈动脉内膜剥脱术老年患者脑氧饱和度及脑血流的影响[J].沈阳药科大学学报,2022,39(12):1515-1520.
[8] Song L,Zhang H,Shen G L.Anesthetic effect of dezocine combined with propofol in laparoscopic surgery and its influence on T cells and inflammatory factors in patients[J].Alternative therapies in health and medicine,2023,29(8):447-451.
[9] 杨彦军,焦岩,段峰,等.苯磺酸瑞马唑仑联合舒芬太尼对宫腔镜手术患者血流动力学及应激反应的影响[J].武警医学,2024,35(3):222-229.
[10] Zhao C,Tang Y,Chen C,et al.The ED_(50)of remazolam toluenesulfonate combined with a subthreshold dose of esketamine for inhibiting cardiovascular response to tracheal intubation in elderly patients[J].Journal of Clinical and Nursing Research,2023,7(6):137-144.