小剂量艾司氯胺酮与苯磺酸瑞马唑仑联合用于肩袖修复术全麻患者的麻醉效果

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Abstract Objective To investigate the anesthetic effect of low-dose esketamine combined with remimazolam in patients during rotator cuff repair and its influence on related indexes. Methods Eighty patients who underwent arthroscopic rotator cuff repair in the Second Hospital of Shanxi Medical University from July 2022 to July 2023 were enrolled and were divided into observation group and control group according to random number table method, with 40 cases in each group. Anesthesia induction of patients in the observation group was taken by sufentanil, rocuronium bromide, etomidate and a low-dose esketamine, while the maintenance was conducted by remimazolam and remifentanil; anesthesia induction of patients in the control group was taken by sufentanil, rocuronium bromide, etomidate, while the maintenance was conducted by propofol and remifentanil. Hemodynamic parameters, awakening time, recovery time of spontaneous respiration, Ricker sedation-restlessness score, VAS score at 6 and 12 h after surgery, stress response indexes, and anesthesia-related adverse reactions were observed in the two groups. Results After anesthesia, systolic blood pressure (112.75±12.59)mmHg, diastolic blood pressure (70.87±6.95) mmHg and heart rate (71.45±7.63) beats/min of patients in the observation group were higher than those of the control group which were (98.37±12.77)mmHg, (65.57±7.46)mmHg and (71.35±6.38)beats/min respectively, and the differences were statistically significant (P<0.05). The time of awakening (4.63±4.72)min and recovery of spontaneous respiration (5.39±0.92) min in the observation group was shorter than the time of awakening (5.29±0.44) min and recovery of spontaneous respiration (8.23±1.34) min in the control group. Ricker sedation-restlessness score and the VAS score of the postoperative period of 6h were lower than those of the control group (P<0.05). the postoperative values of cortisol, epinephrine, ACTH and malondialdehyde in observation group were lower than those in the control group, the postoperative superoxide dismutase were higher than those in the control group, and the incidence of postoperative adverse reactions was lower than that in the control group, with statistical significance (P< 0.05). Conclusions The use of low-dose esketamine combined with remimazolam for anesthesia maintenance in rotator cuff repair can maintain hemodynamic stability, improve the quality of awakening, reduce the stress response, and reduce the incidence of anesthesia-related adverse reactions.

Key words： remimazolam esketamine hemodynamic parameter oxidative stress rotator cuff repair

Received: 07 October 2023

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	GAO Tongtong
	FAN Junbai
	QIN Wenyan
	YIN Hao

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GAO Tongtong,FAN Junbai,QIN Wenyan等. Anesthetic effect of low-dose esketamine combined with remimazolam in patients with general anesthesia during rotator cuff repair[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(7): 562-566.

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https://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR https://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2024/V35/I7/562

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