甲苯磺酸瑞马唑仑联合艾司氯胺酮或瑞芬太尼在无痛胃肠镜检查中的应用对比

Comparison of Rimazolam Mesylate Combined with Esketamine or Remifentanil in Painless Gastroscopy

目的探讨甲苯磺酸瑞马唑仑联合艾司氯胺酮或瑞芬太尼在无痛胃肠镜检查中的应用效果.方法选取2020年5月—2022年5月于我院行无痛胃肠镜检查的88例患者,按随机数字表法分为两组,各44例.对照组采用甲苯磺酸瑞马唑仑联合瑞芬太尼麻醉处理,观察组采用甲苯磺酸瑞马唑仑联合艾司氯胺酮麻醉处理.比较两组血流动力学变化、麻醉情况、疼痛评分及不良反应.结果两组T0时血流动力学相比,差异无统计学意义(P>0.05);观察组T1、T2时舒张压、收缩压、心率均高于对照组,组间差异有统计学意义(P<0.05).观察组麻醉起效时间(1.05±0.23)min、苏醒时间(5.69±1.15)min、定向力恢复时间(12.32±1.25)min及离室时间(22.41±2.35)min均短于对照组,组间差异有统计学意义(P<0.05).观察组苏醒时、苏醒30 min后疼痛视觉模拟评分分别为(1.45±0.22)分、(1.52±0.24)分,均低于对照组,组间差异有统计学意义(P<0.05).两组不良反应发生率相比,差异无统计学意义(P>0.05).结论甲苯磺酸瑞马唑仑联合艾司氯胺酮在无痛胃肠镜检查中的效果更佳,能够提高镇痛效果,减小血流动力学波动,缩短检查后苏醒时间,安全可行.

Objective To investigate the effect of combining rimazolam mesylate with esketamine or remifentanil in painless gastroscopy.Methods 88 patients who underwent painless gastroscopy in our hospital from May 2020 to May 2022 were selected and divided into two groups of 44 patients each according to the random number table method.The control group was treated with remazolam mesylate combined with remifentanil anesthesia,and the observation group was treated with remazolam mesylate combined with esketamine anesthesia.The hemodynamic changes,anesthesia,pain scores and adverse effects were compared between the two groups.Results Compared with the hemodynamics at T0 in the two groups,the difference was not statistically significant(P>0.05);diastolic blood pressure,systolic blood pressure and heart rate at T1 and T2 in the observation group were higher than those in the control group,and the differences between the groups were statistically significant(P<0.05).The onset of anesthesia(1.05±0.23)min,awakening time(5.69±1.15)min,recovery time of orientation(12.32±1.25)min and time to leave the room(22.41±2.35)min in the observation group were shorter than that in the control group,and the differences between the groups were statistically significant(P<0.05).The pain visual simulation score scores at awakening and 30 min after awakening were(1.45±0.22)points and(1.52±0.24)points in the observation group,respectively,which were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).Compared with the incidence of adverse reactions in the two groups,the difference was not statistically significant(P>0.05).Conclusion The combination of rimazolam mesylate and esketamine is more effective in painless gastroscopy,which can improve analgesia,reduce hemodynamic fluctuations,shorten post-examination awakening time,and is safe and feasible.