Zhang Liang, Wang Qing-Hua, Qiu Yi, Ding Yu-Mei, Wang Xiao-Dong, Zhang Zhi-Feng, Zhao Yi-Fan, He Liang-Liang
Department of Anaesthesiology, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
Department of Anaesthesiology, People's Hospital of Ordos Dongsheng District, Ordos, China.
Medicine (Baltimore). 2025 May 2;104(18):e41995. doi: 10.1097/MD.0000000000041995.
This review thoroughly examines the complex interplay between remazolam administration and postoperative cognitive dysfunction (POCD), offering a detailed analysis of POCD's pathogenesis and the pharmacological mechanisms underpinning remazolam's effects. It critically synthesizes existing research findings, highlighting the nuanced nature of the association between remazolam use and POCD. While recognizing the widespread use of remazolam as a sedative, this review identifies its potential to increase susceptibility to POCD, particularly in vulnerable groups such as elderly patients or those exposed to prolonged or high-dose administration. However, it underscores the variability in research outcomes, necessitating a deeper exploration. The review underscores the necessity for tailored guidelines on remazolam administration and advocates for holistic POCD prevention strategies, integrating pharmacological measures with complementary non-pharmacological approaches to enhance patient safety. The review emphasizes the need for rigorous future research, including randomized controlled trials and longitudinal studies, to unravel the intricate dynamics between remazolam use and POCD, providing clinicians with robust evidence to guide optimal patient care.
本综述全面审视了瑞马唑仑给药与术后认知功能障碍(POCD)之间的复杂相互作用,详细分析了POCD的发病机制以及瑞马唑仑作用的药理学机制。它批判性地综合了现有研究结果,突出了瑞马唑仑使用与POCD之间关联的细微差别。在认识到瑞马唑仑作为镇静剂广泛使用的同时,本综述指出其有可能增加对POCD的易感性,尤其是在老年患者或接受长时间或高剂量给药的弱势群体中。然而,它强调了研究结果的变异性,需要进行更深入的探索。该综述强调了制定瑞马唑仑给药定制指南的必要性,并提倡采用全面的POCD预防策略,将药理学措施与补充性非药理学方法相结合,以提高患者安全性。该综述强调未来需要进行严格的研究,包括随机对照试验和纵向研究,以阐明瑞马唑仑使用与POCD之间的复杂动态关系,为临床医生提供有力证据,以指导最佳的患者护理。