瑞马唑仑复合瑞芬太尼麻醉用于无痛胃镜检查中的安全性及对生命体征的影响

Safety of remimazolam combined with remifentanil anesthesia in painless gastroscopy and its effect on vital signs

目的分析瑞马唑仑复合瑞芬太尼麻醉用于无痛胃镜检查中的安全性及对生命体征的影响。方法将我院2020年1月至2021年8月收治的200例实施无痛胃镜检查的患者纳入研究。根据麻醉方案的不同将患者分为常规组(n=100,丙泊酚复合瑞芬太尼麻醉)和观察组(n=100,瑞马唑仑复合瑞芬太尼麻醉)。比较两组的生命体征指标、麻醉深度指标、术中呼吸循环抑制情况、术后不良反应发生情况及临床相关指标。结果T_(0)、T_(1)时,两组患者的生命体征指标(HR、SBP、DBP、SpO_(2)、MAP、RR、ETCO_(2))比较,差异无统计学意义(P>0.05);T_(2)~T_(5)时,观察组的生命体征指标(HR、SBP、DBP、SpO_(2)、MAP、RR、ETCO_(2))均显著高于常规组,差异具有统计学意义(P<0.05);观察组麻醉过程中生命体征指标的波动幅度小于常规组。T_(0)~T_(5)时,两组患者的BIS比较,差异均无统计学意义(P>0.05)。观察组的术中体动反应、心动过缓、低血压、SpO_(2)下降、呼吸抑制发生率均低于常规组,差异具有统计学意义(P<0.05);观察组的术后头晕、恶心呕吐、注射痛发生率均低于常规组,差异具有统计学意义(P<0.05)。两组患者的麻醉起效时间比较,差异无统计学意义(P>0.05);观察组的操作时间、苏醒时间和离室时间均短于对照组,差异具有统计学意义(P<0.05)。结论在无痛胃镜检查中采用瑞马唑仑复合瑞芬太尼麻醉,可维持患者生命体征稳定,提升麻醉的安全性,保障胃镜检查顺利进行。

Objective To analyze the safety of remimazolam combined with remifentanil anesthesia in painless gastroscopy and its effect on vital signs.Methods Two hundred patients who underwent painless gastroscopy in our hospital from January 2020 to August 2021 were included in the study.The patients were divided into routine group(n=100,propofol combined with remifentanil anesthesia)and observation group(n=100,remimazolam combined with remifentanil anesthesia)according to different anesthesia schemes.The vital signs,anesthesia depth,intraoperative respiratory and circulatory inhibition,postoperative adverse reactions and clinical related indexes were compared between the two groups.Results At T_(0),T_(1),there were no significant differences in vital signs indexes(HR,SBP,DBP,SpO_(2),MAP,RR and ETCO_(2))between the two groups(P>0.05);at T_(2)-T_(5),the vital signs indexes(HR,SBP,DBP,SpO_(2),MAP,RR and ETCO_(2))in the observation group were significantly higher than those in the routine group,and the differences were statistically significant(P<0.05);the fluctuation range of vital signs indexes during anesthesia in the observation group was less than that in the routine group.At T_(0)-T_(5),there was no significant difference in BIS between the two groups(P>0.05).The incidences of body dynamic reaction,bradycardia,hypotension,SpO_(2) decreased and respiratory depression during operation in the observation group were lower than those in the routine group,and the differences were statistically significant(P<0.05);the incidences of dizziness,nausea,vomiting and injection pain after operation in the observation group were lower than those in the routine group,and the differences were statistically significant(P<0.05).There was no significant difference in the onset time of anesthesia between the two groups(P>0.05);the operation time,recovery time and time to leave the operating room of the observation group were shorter than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Taking remimazolam combined with remifentanil anesthesia in painless gastroscopy can maintain the stability of patients'vital signs,improve the safety of anesthesia and ensure the smooth progress of gastroscopy.