甲苯磺酸瑞马唑仑联合阿芬太尼在治疗性内镜逆行胰胆管造影中的应用分析

Analysis on the application of remazolam toluene sulfonate combined with alfentanil in the therapeutic endoscopic retrograde cholangiopancreatography

目的探讨甲苯磺酸瑞马唑仑联合阿芬太尼应用于经内镜逆行胰胆管造影术(ERCP)的有效性和安全性。方法选取2020年5月至2021年8月该院64例择期行ERCP的患者为研究对象,按照随机数字表法分为对照组和试验组,每组32例。对照组采用丙泊酚联合阿芬太尼麻醉,试验组采用甲苯磺酸瑞马唑仑联合阿芬太尼麻醉,以脑电双频指数(BIS)作为个体化麻醉深度监测指标,术中均维持BIS值40~60。比较两组手术时间、入睡时间、苏醒时间、离科时间及麻醉前、进镜时、手术后10 min和术毕时的血流动力学指标[心率(HR)、收缩压(SBP)、血氧饱和度(SpO_(2))]及BIS值变化情况、麻醉相关并发症、术后并发症等的差异。结果试验组苏醒时间和离科时间较对照组明显缩短,差异有统计学意义(P<0.05)。两组麻醉前HR、SBP、SpO_(2)比较,差异无统计学意义(P>0.05),但手术后10 min和术毕时,试验组HR、SBP、SpO_(2)优于对照组(P<0.05);两组各时点BIS值比较,差异无统计学意义(P>0.05)。试验组注射痛发生率低于对照组(P<0.05),且试验组未发生术后严重并发症,对照组出现1例术后迟发出血,经积极对症止血治疗后缓解。结论甲苯磺酸瑞马唑仑联合阿芬太尼用于治疗性ERCP安全可行。

Objective To investigate the effectiveness and safety of remazolam toluene sulfonate combined with alfentanil in the therapeutic endoscopic retrograde cholangiopancreatography(ERCP).Methods A total of 64 patients undergoing elective ERCP in this hospital were randomly divided into the control group(n=32)and the research group(n=32)by the random number table method.The control group was anesthetized with propofol combined with alfentanil,while the research group was anesthetized with remazolam toluene sulfonate combined with alfentanil.The bispectral index(BIS)was used as an indicator for monitoring the depth of individual anesthesia,and the BIS value was maintained at 40-60 during the operation.The operation time,time of fall asleep,wake-up time,leave time and hemodynamic indexes[heart rate(HR),systolic blood pressure(SBP),blood oxygen saturation(SpO_(2))],BIS value of the perioperative period,anesthesia-related complications,and postoperative complications were compared between the two groups.Results The wake-up time and leave time of the research group were significantly shorter than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the HR,SBP and SpO_(2) between the two groups before the anesthesia(P>0.05).However,ten minutes after the operation and at the end of the operation,the HR,SBP and SpO_(2) of the research group were better than those of the control group(P<0.05).There was no significant difference in the BIS value between the two groups at each time point(P>0.05).The incidence of injection pain of the research group was lower than that of the control group(P<0.05).There were no postoperative complications in the research group.In the control group,there was one case of delayed bleeding after operation,which was relieved after active symptomatic hemostasis.Conclusion Remazolam toluenesulfonate combined with alfentanil intravenous anesthesia is safe and feasible for the patients undergoing therapeutic ERCP.