[1]滕云鹏,何家璇,李思远,等.瑞马唑仑联合帕瑞昔布钠在老年患者经皮椎间孔镜下髓核摘除术中的麻醉效果及安全性研究[J].陕西医学杂志,2021,50(12):1562-1565, 1569.[doi:DOI:10.3969/j.issn.1000-7377.2021.12.024]
　TENG Yunpeng,HE Jiaxuan,LI Siyuan,et al.Anesthetic effect and safety of remazolam combined with parecoxib sodium in elderly patients with percutaneous transforaminal endoscopic discectomy[J].,2021,50(12):1562-1565, 1569.[doi:DOI:10.3969/j.issn.1000-7377.2021.12.024]
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瑞马唑仑联合帕瑞昔布钠在老年患者经皮椎间孔镜下髓核摘除术中的麻醉效果及安全性研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年12期
页码:
1562-1565, 1569
栏目:
药物与临床
出版日期:
2021-12-05

文章信息/Info

Title:
Anesthetic effect and safety of remazolam combined with parecoxib sodium in elderly patients with percutaneous transforaminal endoscopic discectomy
作者:
滕云鹏; 何家璇; 李思远; 韩潇瑶; 薛荣亮; 熊虹飞
(西安国际医学中心医院,陕西 西安 710100)
Author(s):
TENG Yunpeng; HE Jiaxuan; LI Siyuan; HAN Xiaoyao; XUE Rongliang; XIONG Hongfei
(Xi'an International Medical Center Hospital,Xi'an 710100,China)
关键词:
经皮椎间孔镜下髓核摘除术;  瑞马唑仑;  帕瑞昔布钠;  老年患者;  麻醉效果;  安全性
Keywords:
Percutaneous transforaminal endoscopic discectomy;  Remimazolam;  Parecoxib sodium;  Elderly patients;  Anesthetic effect;  Safety
分类号:
R 971.2
DOI:
DOI:10.3969/j.issn.1000-7377.2021.12.024
文献标志码:
A
摘要:
目的:探讨瑞马唑仑联合帕瑞昔布钠在老年患者经皮椎间孔镜下髓核摘除术中的麻醉效果及安全性。方法:选择行经皮椎间孔镜下髓核摘除术的老年患者40例,采用随机数字表法分为对照组和试验组,每组20例。对照组采用1%利多卡因20 ml局部逐层浸润麻醉。试验组静脉单次注射帕瑞昔布钠后行局部麻醉(方法同对照组),静脉注射瑞马唑仑0.15 mg/kg,随后静脉泵注瑞马唑仑0.4 mg/(kg·h)维持镇静,手术结束前5 min停用。比较两组患者入室后(T0)、切皮时(T1)、打磨小关节时(T2)、髓核摘除时(T3)、手术结束(T4)时平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、呼气末二氧化碳分压(ETCO2)、数字评价量表(NRS)评分、焦虑自评量表(SAS)评分。比较两组患者术后不良反应和满意情况。结果:T1-T3时,试验组MAP、HR和RR均低于对照组,ETCO2高于对照组(均P<0.05)。T0和T4时,两组以上各指标比较差异无统计学意义(均P>0.05)。T1-T4时,试验组NRS评分和SAS评分低于对照组(均P<0.05)。试验组患者术后不良反应总发生率低于对照组,患者满意度高于对照组(均P<0.05)。结论:瑞马唑仑联合帕瑞昔布钠可安全有效地应用于老年患者椎间孔镜髓核摘除术麻醉,既有助于缓解患者紧张情绪,维持血流动力学平稳,又可降低患者术后不良反应,提高患者满意度。
Abstract:
Objective:To explore the anesthetic effect and safety of remazolam combined with parecoxib sodium in the elderly with percutaneous transforaminal endoscopic discectomy.Methods:Forty elderly patients who underwent percutaneous transforaminal endoscopic discectomy were selected and divided into control group and experimental group by random number table method,with 20 cases in each group.In the control group,20 ml of 1% lidocaine was used for local infiltration anesthesia.The experimental group received local anesthesia after single intravenous injection of parecoxib sodium(the method was the same as that of the control group),intravenous injection of remazolam 0.15 mg/kg,followed by intravenous pump injection of remazolam 0.4 mg/(kg·h)for maintenance sedation,and stopped 5 minutes before the end of the operation.The mean arterial pressure(MAP),heart rate(HR),respiratory frequency(RR),end-tidal carbon dioxide partial pressure(ETCO2),numerical rating scale(NRS)score,self-rating anxiety scale(SAS)score at T0(after entering the room),T1(incisioned skin),T2(grinded facet joint),T3(removal of the nucleus pulposus),T4(the end of the operation)of two groups were compared.The adverse reactions and satisfaction of the two groups were compared.Results:At T1-T3,the MAP,HR and RR of the experimental group were lower than those of the control group,and ETCO2 was higher than that of the control group(all P<0.05).At T0 and T4,there was no statistically significant difference in the above indicators between the two groups(all P>0.05).At T1-T4,the NRS score and SAS score of the experimental group were lower than those of the control group(both P<0.05).The total incidence of adverse reactions in the experimental group was lower than that in the control group,and satisfaction of patients was higher than that in the control group(all P<0.05).Conclusion:Remazolam combined with parecoxib sodium can be used safely and effectively in the anesthesia of elderly patients with percutaneous transforaminal endoscopic discectomy.It not only relieve the nervousness of patients,maintain hemodynamic stability,but also reduce adverse reactions of patients after surgery,improve satisfaction of patients.

参考文献/References:

[1] 高国勇,陈廖斌,镇万新,等.经皮椎间孔镜微创技术治疗腰椎间盘突出症[J].中华显微外科杂志,2012,35(5):423-425.
[2] Sairyo K,Egawa H,Matsuura T,et al.State of the art:Transforaminal approach for percutaneous endoscopic lumbar discectomy under local anesthesia[J].J Med Invest,2014,61(3-4):217-225.
[3] 刘 波,叶泳均,王泽波,等.枸橼酸芬太尼联合帕瑞昔布钠在椎间孔镜手术中的镇痛、镇静效果[J].中国医药导报,2018,15(22):99-102.
[4] 李 伟,邱龙顺,黄 新,等.经皮椎间孔镜椎间盘切除术与经椎间孔椎体间融合术治疗腰椎间盘突出合并椎管狭窄症疗效对比研究[J].陕西医学杂志,2021,50(3):319-322.
[5] 吕雪丰,白晓杰,曹璧莹.经皮椎间孔镜髓核摘除术配合康复治疗腰椎间盘突出症的临床研究分析[J].河北医学,2017,23(12):1958-1962.
[6] 徐仲林,蒋赞利.经皮椎间孔镜技术的发展、治疗范围、并发症及特点[J].东南大学学报:医学版,2015,34(3):452-455.
[7] 管飞杰,骆喜宝.帕瑞昔布钠超前镇痛联合右美托咪定复合局部麻醉在经皮椎间孔镜手术中的应用研究[J].现代医药卫生,2019,35(11):1613-1615.
[8] 王思媛,师 玮,贾洪峰.右美托咪定联合硬膜外麻醉用于腰椎间盘髓核摘除术的临床疗效及其安全性评价[J].陕西医学杂志,2017,46(8):1060-1061.
[9] Ren Z,He S,Li J,et al.Comparison of the safety and effectiveness of percutaneous endoscopic lumbar discectomy for treating lumbar disc herniation under epidural anesthesia and general anesthesia[J].Neurospine,2020,17(1):254-259.
[10] 任伟剑,刘 军,王红伟,等.全身麻醉下经皮椎间孔镜治疗腰椎间盘突出症的疗效分析[J].局解手术学杂志,2021,30(5):400-404.
[11] Stafford JA,Pacofsky GJ,Cox RF,et al.Identification and structure-activity studies of novel ultrashort-acting benzodiazepine receptor agonists[J].Bioord Med ChenLett,2002,12(21):3215-3218.
[12] Basavana GG,Preet MS.Remimazolam:The future of its sedative potential[J].Saudi Anaesth,2014,8(3):388-391.
[13] 王春艳,于泳浩.瑞马唑仑临床研究进展[J].中华麻醉学杂志,2019,39(3):261-263.
[14] 邓 奋,邓铸强,杜志斌.帕瑞昔布钠在开颅手术患者术后镇痛中的应用效果[J].辽宁医学院学报,2016,37(4):61-64.
[15] 李 敏,董美荣,余 昌,等.氟比洛芬酯和帕瑞昔布钠注射液在骨科手术超前镇痛及术后镇痛中的效果对比[J].中国当代医药,2018,25(26):128-130.
[16] Malan TP,Marsh G,Hakki SI,et al.Parecoxib sodium,a parenteral cyclooxygenase-2 selective inhibitor,improves morphine analgesia and is opioid-sparing following total hip arthroplasty[J].Anesthesiology,2003,98(14):950-956.
[17] 何秀莉,苏鸿莉.帕瑞昔布钠复合小剂量舒芬太尼用于老年股骨头置换术后患者的镇痛[J].陕西医学杂志,2015,44(10):1411-1412.
[18] 吴运香,魏 昕,章 敏,等.帕瑞昔布钠对老年患者胃癌术后早期认知功能的影响[J].临床麻醉学杂志,2015,31(4):320-322.
[19] 刘 海,陈 刚,王志红,等.帕瑞昔布钠超前镇痛对老年患者应激、炎性反应及术后认知功能的影响[J].中华临床医师杂志:电子版,2014,8(12):2238-2241.
[20] 赵 婷,肖春龙.帕瑞昔布钠超前镇痛对老年髋骨骨折患者术后应激反应、 镇痛和谵妄的影响[J].解放军医药杂志,2018,30(6):105-108.

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备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2018SF-010)
更新日期/Last Update: 2021-12-07