瑞马唑仑联合瑞芬太尼在无痛胃镜麻醉中的应用及对血流动力学指标的影响

Application of remimazolam combined with remifentanil in painless gastroscopy anesthesia and its influence on hemodynamic indexes

目的探讨无痛胃镜麻醉中采用瑞马唑仑联合瑞芬太尼的效果及对血流动力学指标的影响。方法选取2020年1月至2021年1月在潜江市中心医院进行无痛胃镜检查的患者92例作为研究对象,根据随机数字表法分为观察组(n=46)和对照组(n=46),对照组使用丙泊酚联合瑞芬太尼进行麻醉,观察组使用瑞马唑仑联合瑞芬太尼进行麻醉,比较两组患者麻醉效果、血流动力学、呼吸循环及不良反应。结果两组药物起效时间比较差异无统计学意义(P>0.05),观察组苏醒时间、定向力恢复时间短于对照组,差异有统计学意义(P<0.05);两组给药后1、5、10 min心率(HR)及平均动脉压(MAP)均存在明显波动,但观察组波动小于对照组,差异有统计学意义(P<0.05);两组检查后呼气末二氧化碳(PetCO2)、气道压力(AWP)明显提高,但观察组低于对照组,差异有统计学意义(P<0.05);观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论无痛胃镜使用瑞马唑仑联合瑞芬太尼进行麻醉,能够提高麻醉效果,减轻对血流动力学及呼吸循环的影响,降低不良反应发生率。

Objective To explore the effect of remimazolam combined with remifentanil in painless gastroscopy anesthesia and its influence on hemodynamic indexes.Methods A total of 92 patients who underwent painless gastroscopy examination in Qianjiang Central Hospital from January 2020 to January 2021 were selected as the research objects,and were randomly divided into the observation group(n=46)and the control group(n=46)according to the random number table method.The control group was anesthetized with propofol combined with remifentanil,while the observation group was anesthetized with remimazolam combined with remifentanil.The anesthetic effect,hemodynamics,respiratory circulation and adverse reactions were compared between the two groups.Results There was no statistically significant difference in the onset time of medicine between the two groups(P>0.05),but the awakening time and recovery time of orientation of the observation group were shorter than that of the control group,with statistically significant differences(P<0.05).The heart rate(HR)and mean arterial pressure(MAP)in the two groups fluctuated significantly at 1,5 and 10 min after administration,but the fluctuations in the observation group were smaller than those in the control group,with statistically significant differences(P<0.05).After examination,the end-expiratory carbon dioxide(PetCO2)and airway pressure(AWP)in the two groups were significantly increased,but the levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,with statistically significant difference(P<0.05).Conclusion Remimazolam combined with remifentanil for painless gastroscopy anesthesia can improve the anesthetic effect,reduce the influence on hemodynamics and respiratory circulation,and reduce the incidence of adverse reactions.