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丙泊酚、低剂量和高剂量瑞马唑仑对腹腔镜手术血流动力学及炎症反应的影响。

Effects of Propofol, Low and High Doses of Remimazolam on Hemodynamic and Inflammatory Response in Laparoscopic Surgery.

机构信息

The Anesthesiology Surgery Center of The Third Affiliated Hospital of Sun Yat-sen University-Yuedong Hospital, Guangdong, People's Republic of China.

出版信息

Drug Des Devel Ther. 2024 Jul 30;18:3329-3336. doi: 10.2147/DDDT.S459885. eCollection 2024.

Abstract

BACKGROUND

This study explored the effects of different doses of remimazolam tosilate (RT) and propofol combined with remifentanil anesthesia on hemodynamic and inflammatory responses in patients undergoing laparoscopic surgery.

SUBJECTS AND METHODS

Ninety patients with a BMI of less than 35 kg/m², classified as ASA II-III and scheduled for laparoscopic surgery, were enrolled in this study. Patients were divided into three groups: low-dose RT group (A), high-dose RT group (B), and propofol group (C). The changes in hemodynamic indices such as SBP, DBP, HR, MAP, and inflammatory response indices such as IL-6, SAA, CRP, and PCT, along with extubation time and doses of sufentanil, remifentanil, urapidil, and phenylephrine, were compared among the three groups.

RESULTS

There were no statistically significant differences in extubation time, doses of sufentanil and remifentanil, or the usage rates and average doses of urapidil and phenylephrine between the three groups. The average dose of phenylephrine in group A was lower than in group B and group C, with a statistically significant difference. There were no statistically significant differences among the groups in SBP, DBP, HR, and MAP from T0 to T2, nor in IL-6, SAA, CRP, or PCT levels.

CONCLUSION

Using RT for induction and maintenance of anesthesia in laparoscopic surgery ensures stable hemodynamic and inflammatory responses in patients. Low-dose RT may reduce the usage rate and dose of vasopressors such as phenylephrine during surgery.

摘要

背景

本研究旨在探讨不同剂量甲苯磺酸雷米佐仑(RT)与丙泊酚联合瑞芬太尼麻醉对腹腔镜手术患者血流动力学和炎症反应的影响。

受试者和方法

本研究纳入了 90 例 BMI 小于 35kg/m²、ASA 分级 II-III 级、拟行腹腔镜手术的患者。将患者分为三组:低剂量 RT 组(A 组)、高剂量 RT 组(B 组)和丙泊酚组(C 组)。比较三组患者的血流动力学指标(如 SBP、DBP、HR、MAP)和炎症反应指标(如 IL-6、SAA、CRP、PCT)的变化,以及拔管时间和舒芬太尼、瑞芬太尼、乌拉地尔、去甲肾上腺素的用量。

结果

三组患者的拔管时间、舒芬太尼和瑞芬太尼用量、乌拉地尔和去甲肾上腺素的使用率和平均剂量无统计学差异。A 组的去甲肾上腺素平均剂量低于 B 组和 C 组,差异有统计学意义。三组患者 T0 至 T2 时 SBP、DBP、HR 和 MAP 无统计学差异,IL-6、SAA、CRP 和 PCT 水平也无统计学差异。

结论

在腹腔镜手术中使用 RT 进行诱导和维持麻醉可确保患者血流动力学和炎症反应稳定。低剂量 RT 可能减少手术期间血管加压药(如去甲肾上腺素)的使用率和剂量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48f4/11298169/6584bdc9898e/DDDT-18-3329-g0001.jpg

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