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Outline
Elderly patients with hip fracture have a high incidence of perioperative neurocognitive disorders (PND), poor prognosis and high resource consumption. Remazolam has the pharmacokinetic advantages of esterase metabolism, predictable recovery and hemodynamic friendliness, and can be quickly reversed by flumazenil, making it suitable for people with advanced age, insufficient organ reserve or high risk of cognitive complications. Recent studies have shown that remazolam can reduce the level of postoperative inflammatory markers, improve early cognitive function and reduce the incidence of delirium, while retaining good hemodynamic stability and controllable recovery characteristics. The underlying mechanism involves the inhibition of excessive activation of microglia and neuroinflammatory response, reduction of systemic inflammatory response, reduction of stress and pain intensity, and reduction of cerebral hypoperfusion events and other pathways to produce neuroprotective effects. Therefore, this paper integrates the latest evidence of the molecular mechanism, pharmacological characteristics and clinical application of remazolam in the prevention and treatment of perioperative neurocognitive disorders in elderly patients with hip fracture, and emphasizes its potential value in optimizing perioperative anesthesia management of elderly hip fracture. It is expected to provide a theoretical basis for future high-quality, multi-center, long-term follow-up clinical research, and provide reference for individualized perioperative strategy formulation and PND prevention and treatment.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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