Lung Protection Effect of Remazolam Under Lung Protective Ventilation Strategy in Elderly Patients Undergoing Laparoscopic Upper Abdominal Surgery
10.3969/j.issn.1009-6604.2025.06.004
- VernacularTitle:肺保护通气策略下瑞马唑仑对老年患者腹腔镜上腹部手术的肺保护效果
- Author:
Guoqiang ZHANG
1
;
Haibin WU
1
;
Jianying OU
1
Author Information
1. 广东省佛山市南海区第四人民医院麻醉科,佛山 528211
- Publication Type:Journal Article
- Keywords:
Lung protection ventilation strategy;
Remazolam;
Propofol;
Elderly patient;
Laparoscopic upper abdominal surgery
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(6):342-347
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the lung protection effect of remazolam under lung protection ventilation strategy in elderly patients undergoing laparoscopic upper abdominal surgery.Methods A prospective randomized controlled study was conducted on 60 patients aged 60 years or older who were scheduled to undergo laparoscopic upper abdominal surgery,including cholecystectomy,common bile duct choledocholithotomy,partial hepatectomy,and subtotal gastrectomy from October 2023 to October 2024.The patients were divided into 2 groups by random number table method:30 patients in the observation group received lung protective ventilation strategy and remazolam administration,and 30 patients in the control group received lung protective ventilation strategy and propofol administration.The inflammatory response indexes(TNF-α,IL-6,and hs-CRP),stress indexes(SOD,NE,and Cor),anesthesia quality(VAS score and Ramsay score),lung function(FVC,FEV1,and MVV％),blood gas indexes(pH,Lac,PaO2,and PaCO2),recovery quality(tracheal tube extubation time,respiratory recovery time,and awakening time),and pulmonary complications were compared between the two groups.Results In the observation group,the serum levels of inflammatory markers of TNF-α,IL-6,and hs-CRP at 2,12,and 24 h postoperatively were all lower than those in the control group(all P=0.000).Regarding stress response indicators,the serum SOD levels in the observation group were higher than those in the control group at 2,12,and 24 h postoperatively,while the NE and Cor levels were lower(all P=0.000).The VAS scores at 24 h postoperatively,and the Ramsay scores at 2 and 24 h postoperatively in the observation group were lower than those in the control group(all P=0.000).In the observation group,the FVC,FEV1,and MVV％were all higher than those in the control group at 48 h postoperatively(P＜0.05).The PaO2 level in the observation group was higher than that in the control group at 24 h postoperatively,and the Lac level was lower(P＜0.05).The respiratory recovery time and awakening time in the observation group were both shorter than those in the control group(P＜0.05).There were no significant differences between the two groups in extubation time and pulmonary complications(P＞0.05).Conclusions The lung protection effect of remazolam under lung protection ventilation strategy is better than that of propofol in elderly patients undergoing laparoscopic upper abdominal surgery.The lung protective effects may be achieved by alleviating perioperative stress response,improving oxygenation function,effective sedation,and reducing inflammatory response.
