不同剂量瑞马唑仑联合舒芬太尼在实施神经阻滞麻醉的青年和老年患者中镇静效果的比较:一项随机对照研究

以下文章来源于罂粟花，作者anesthGH

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不同剂量瑞马唑仑联合舒芬太尼在实施神经阻滞麻醉的青年和老年患者中镇静效果的比较:一项随机对照研究

贵州医科大学    麻醉与心脏电生理课题组

翻译：安丽

编辑：宋雨婷

审校：曹莹

背景

焦虑和疼痛是神经阻滞过程中常见的症状，本研究旨在探讨不同剂量的瑞马唑仑与舒芬太尼在青年和老年患者中的镇静效果。

方法

该随机试验纳入年龄在18-85岁接受神经阻滞的90名年轻患者和114名老年患者。所有患者均给予舒芬太尼0.08 μg/kg。将年轻患者（年龄<65岁）随机分为对照组(C组，0.9%生理盐水)、中剂量瑞马唑仑组(M组，0.06 mg/kg)和高剂量瑞马唑仑组(H组，0.08 mg/kg)。老年患者（年龄≥65岁）被随机分为C组、低剂量瑞马唑仑组(L组，0.04 mg/kg)和中剂量瑞马唑仑组(M组，0.06 mg/kg)组。主要结局指标为手术镇静成功率，呼吸抑制和缺氧发生的情况。

结果

与C组和M组相比，H组的年轻患者手术镇静成功率最高（80.0比73.3比43.3%，P =0.006）。M组和L组的老年患者手术镇静成功率相似，显著高于C组（78.9比78.9比50.0%，P =0.007）。在老年患者中，M组的呼吸抑制和缺氧发生率高于L组和C组（P <0.001）。

结论

0.08 mg/kg的瑞马唑仑对年轻患者的镇静效果最好，而0.04 mg/kg的瑞马唑仑对老年患者的镇静效果更佳，且呼吸不良事件发生率较小。

原始文献来源

Xue Li， Tegeleqi Bu， Yu‑Ting Li，Ke‑Qi Xie，Zhen‑Zhen Xu，Xin‑Quan Liang， Dong‑Liang Mu.Sedation efcacy of diferent dose of remimazolam with sufentanil for nerve block in young and elderly patients: a randomized, controlled study.Journal of Anesthesia (2023) 37:177–185.

英文原文

Sedation efficacy of different dose of remimazolam with sufentanil  for nerve block in young and elderly patients: a randomized,  controlled study

Background: Anxiety and pain commonly occur during nerve block, we aimed to investigate the sedation efcacy of diferent doses of remimazolam with sufentanil in young and elderly patients.

Methods:In this randomized trial, patients aged 18–85 years who underwent nerve block was enrolled. All patients received sufentanil 0.08 μg/kg for analgesia. Young patients (age<65 years) were randomized into the control group (Group C, 0.9% saline), medium-dose remimazolam (Group M, 0.06 mg/kg) and high-dose remimazolam group (Group H, 0.08 mg/kg). Elderly patients (age≥65 years) were randomized into the Group C, low-dose remimazolam group (Group L, 0.04 mg/kg) and Group M. Primary outcome was the success rate of procedure sedation. Respiratory depression and hypoxia were the interested safety outcomes.

Results: Ninety young and 114 elderly patients were enrolled, respectively. In comparison with Groups C and M, young patients in Group H had the highest success rate of procedure sedation (80.0 vs. 73.3 vs. 43.3%, P=0.006). Elderly patients in Groups M and L had similar success rates of procedure sedation, which were signifcantly higher than that in Group C (78.9 vs. 78.9 vs. 50.0%, P=0.007). In elderly patients, the incidence of respiratory depression and hypoxia tended to be higher in Group M than those in Groups L and C (both P<0.001).

Conclusion: Remimazolam 0.08 mg/kg provided the best sedation efcacy in young patients while remimazolam 0.04 mg/kg with the trend of less respiratory adverse events was more optimal for elderly patients.

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编辑：MiLu.米鹭

校对：Michel.米萱  

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