异丙酚、低剂量和高剂量雷马唑仑对腹腔镜手术血流动力学和炎症反应的影响

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2024-07-30 DOI:10.2147/dddt.s459885

Wenguang Deng, Zhiming Zeng, Qingyan Liu, Jingjing Deng, Liyu Wang, Hui Li, Yuenong Zhang

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引用次数: 0

摘要

背景：本研究探讨了不同剂量的替磺酸雷马唑仑（RT）和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：本研究招募了 90 名体重指数小于 35 kg/m²、ASA 分级为 II-III 级并计划接受腹腔镜手术的患者。患者被分为三组：低剂量 RT 组（A）、高剂量 RT 组（B）和异丙酚组（C）。比较三组患者的 SBP、DBP、HR、MAP 等血流动力学指标和 IL-6、SAA、CRP、PCT 等炎症反应指标的变化，以及拔管时间和舒芬太尼、瑞芬太尼、乌拉地尔、苯肾上腺素的剂量：三组患者的拔管时间、舒芬太尼和瑞芬太尼的剂量、乌拉地尔和苯肾上腺素的使用率和平均剂量均无统计学差异。A 组的苯肾上腺素平均剂量低于 B 组和 C 组，差异有统计学意义。从 T0 到 T2，各组之间的 SBP、DBP、HR 和 MAP，以及 IL-6、SAA、CRP 或 PCT 水平均无明显统计学差异：结论：在腹腔镜手术中使用 RT 诱导和维持麻醉可确保患者血流动力学和炎症反应的稳定。小剂量 RT 可减少手术中血管加压药（如苯肾上腺素）的使用率和剂量。

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

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.

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.