ABSTRACT
Objective:To evaluate the effects of remazolam and propofol on the hemodynamics during induction of anaesthesia in elderly patients using the area under curve (AUC) method.Methods:Eighty elderly patients of either sex, aged 65-75 yr, with body mass index of 20-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective non-cardiac surgery, were divided into 2 groups ( n=40 each) by using a random number table method: remazolam group (R group) and propofol group (P group). Remazolam 1 mg/ml or propofol 10 mg/ml was slowly and intravenously injected through titration to achieve loss of responsiveness to verbal command. The accumulative areas under the curve below (AUC MAP-) or above (AUC MAP+ ) baseline mean arterial pressure and under the curve below or above 10% of baseline heart rate at the same time (AUC HR-, AUC HR+ ) were calculated within the first 10 min after administration of propofol or remazolam. The use of vasoactive drugs and injection pain were recorded during this period. The intraoperative awareness during the 24-h follow-up after surgery and development of cardiovascular complications, cerebral infarction and oliguria or anuria within 30 days after surgery were recorded. Results:Compared with R group, AUC MAP- was significantly enlarged (the mean difference 59.375 mmHg·min, 95% confidence interval 26.763-91.987 mmHg·min), AUC HR- was enlarged ( P<0.05), and no significant change was found in AUC MAP+, AUC HR+, requirement for vasoactive drugs, frequency of vasoactive drugs, and postoperative complications in P group ( P>0.05). No injection pain or intraoperative awareness was found in two groups. Conclusions:Remazolam is superior to propofol in maintaining hemodynamic stability during anesthesia induction in elderly patients.
ABSTRACT
Objective To discuss influence of sulfentanyl on hemodynamics and stress reaction on patients with opera-tions on cranium and brain during anesthesia induction period. Methods A total of 100 cases of clinical information of patients with severe brain injury were divided into two groups in accordance with different anesthetic methods, with 50 cases in anesthesia group A (fentanyl as anesthetic method) and 50 cases in anesthesia group B (sulfentanyl as anesthetic method). The changes of MAP, HR, cortisol (Cor) in plasma and glucose (Glu) in blood before the anesthesia induction (T0), 2 minutes after anesthesia induction and before the trachea cannula (T1), 1 minute after the trachea cannula (T2), upon the incision of scalp (T3), upon the drilling of skull (T4), and upon the withdrawal of trachea cannu-la (T5) were observed. Results The MAP and HR of patients in anesthesia group B at T1, T2, T3, T4 and T5 were all lower than those in anesthesia group A (P<0.05). The Cor in plasma and Glu in blood of patients with severe brain injury in anesthesia group B at T2, T3, T4 and T5 were all lower than those in anesthesia group A(P<0.05). Conclusion Compared with fentanyl, the application of sulfentanyl on patients with severe brain injury has more favorable curative effect on hemodynamics and stress reaction during anesthesia induction period, which can maintain the circulatory sys-tem more stable, is more suitable for the anesthesia induction.