【罂粟摘要】瑞马唑仑和丙泊酚对接受髋关节置换术老年患者全麻苏醒期躁动的影响：一项临床、随机、对照研究

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瑞马唑仑和丙泊酚对接受髋关节置换术老年患者全麻苏醒期躁动的影响：一项临床、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：马艳燕

编辑：柏雪

审校：曹莹

目的：本研究的目的是比较瑞马唑仑和丙泊酚对接受髋关节置换术的老年患者出现全麻苏醒期躁动（EA）的影响。

方法：从2023年2月至4月，共有60名老年髋关节置换术患者参加了这项前瞻性、单中心、临床、随机、对照研究。将60名患者随机分为两组：瑞马唑仑组(R组)和丙泊酚组(P组)。R组在麻醉诱导和维持期间静脉注射瑞马唑仑，P组在麻醉诱导和维持期间使用丙泊酚。记录EA的发生率为主要指标。次要指标包括以下时刻的心率（HR）和平均动脉压（MAP）值：麻醉诱导前5min(T0)、诱导后1min(T1)、置入喉罩后5min(T2)、手术开始时(T3)、拔出喉罩的瞬间(T4)，以及术后不良事件（手术切口出血或裂开、静脉输液针脱出、坠床、低氧血症和高血压）的总发生率。

结果：R组EA的发生率显著低于P组（10% vs 33%，P＜0.05）。在 T1、T2和 T3时，R组HR和MAP值均高于P组（P＜0.05）。R组术后不良事件的总发生率显著低于P组（P＜0.05）。

结论：与丙泊酚相比，瑞马唑仑进一步降低了老年髋关节置换术中全麻苏醒期躁动的发生率。此外，瑞马唑仑对血流动力学影响小，并降低了术后不良事件的发生率。

原始文献来源：Jinjuan Duan , Xia Ju, Xing Wang, et, al. Effects of Remimazolam and Propofol on Emergence Agitation in Elderly Patients Undergoing Hip Replacement: A Clinical, Randomized, Controlled Study. Drug Design, Development and Therapy 2023:17 2669–2678

英文原文：

Effects of Remimazolam and Propofol on Emergence Agitation in Elderly Patients Undergoing Hip Replacement: A Clinical, Randomized, Controlled Study

Purpose: The aim of this study was to compare the effects of remimazolam and propofol on emergence agitation (EA) in elderly patients undergoing hip replacement.

Methods: A total of 60 elderly patients undergoing hip replacement were recruited for this prospective, single-center, clinical, randomized, controlled study from February to April 2023. They were randomly assigned to two groups: the remimazolam group (group R) and the propofol group (group P). In group R, remimazolam was administered intravenously during the induction and maintenance of anesthesia, In group P, propofol was used during the induction and maintenance of anesthesia. The incidence of EA was recorded as the primary indicator. Secondary indicators included heart rate (HR) and mean arterial pressure (MAP) values at the following moments: 5 min prior to anesthetic induction (T0), 1 min following induction (T1), 5 min after the laryngeal mask was inserted (T2), the beginning of surgery (T3), the moment the laryngeal mask was removed (T4), and the overall incidence of postoperative adverse events (bleeding or splitting of the surgical incision, removal of the intravenous infusion needle, falling off the bed, hypoxemia, and hypertension).

Results: The incidence of EA was significantly lower in group R than in group P (10% vs 33%, P < 0.05). At T1, T2, and T3, the HR and MAP values of group R were higher than those of group P (P < 0.05). The overall incidence of postoperative adverse events was significantly lower in group R than in group P (P < 0.05).

Conclusion: Remimazolam further reduced the incidence of emergence agitation when compared to propofol during geriatric hip replacement. Moreover, it has a minor hemodynamic effect and lower the incidence of postoperative adverse events.

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