瑞马唑仑复合舒芬太尼用于无痛超声胃镜检查的麻醉效果

The Anesthesia Efficacy of Remimazolam Combined with Sufentanil Used for Painless Ultrasound Gastroscopy

目的:评价不同剂量瑞马唑仑用于无痛超声胃镜检查术的安全性和有效性。方法:选取南昌大学第一附属医院行无痛超声胃镜检查患者160例,采用随机数字表法分为四组(n=40),分别为对照组P组(丙泊酚复合舒芬太尼)和试验组R1组(瑞马唑仑0.2 mg/kg复合舒芬太尼)、R2组(瑞马唑仑0.25 mg/kg复合舒芬太尼)、R3组(瑞马唑仑0.3 mg/kg复合舒芬太尼)。麻醉诱导均缓慢静注0.1 μg/kg舒芬太尼,2 min后,P组静注2 mg/kg丙泊酚诱导,R1组、R2组、R3组分别静注瑞马唑仑0.2 mg/kg、0.25 mg/kg、0.3 mg/kg诱导,试验组、对照组静脉分别泵注丙泊酚和瑞马唑仑维持麻醉。记录镇静起效时间和成功率,记录不同时间点生命体征,检查时间、苏醒时间、离院时间,不良反应发生情况。结果:各组胃镜检查时间、苏醒时间、离室时间比较差异无统计学意义(P>0.05);麻醉诱导后试验组心率、血压都高于对照组(P<0.05);与P组比较,R1组镇静成功率低,镇静起效时间长,术中体动反应、呛咳发生率高(P<0.05);R2组术中低氧血症、低血压发生率低(P<0.05);R3组的镇静成功率高,镇静起效时间短,体动反应、呛咳、低氧血症、低血压发生率低(P<0.05)。结论:0.3 mg/kg瑞马唑仑复合舒芬太尼用于无痛超声胃镜检查,其有效性和安全性较高。

Objective:To evaluate the safety and efficacy of different doses remimazolam in painless ultrasound gastroscopy.Methods:A total of 160 patients underwent painless ultrasonic gastroscopy in The First Affiliated Hospital of Nanchang University were selected and divided into 4 groups (n=40 each) by random number table method:control group P (propofol combined with sufentanil) and experimental group R1 (remimazolam 0.2 mg/kg combined with sufentanil),group R2 (remimazolam 0.25 mg/kg combined with sufentanil) and R3 (remimazolam 0.3 mg/kg combined with sufentanil).Anesthesia was induced by slow intravenous administration sufentanil 0.1 μg/kg.2 minutes later,group P was induced by propofol 2 mg/kg intravenously,R1,R2 and R3 groups were induced by intravenous injection of 0.2 mg/kg,0.25 mg/kg and 0.3 mg/kg remimazolam,respectively,then propofol and remimazolam were pumped intravenously in experimental group and control group respectively to maintain anesthesia.Success rate and the onset time of sedation,vital signs at different time points,time for gastroscopy,awakening time,discharge time,and the occurrence of adverse reactions were recorded.Results:There were no differences in the time of gastroscopy,time of awakening and time of leaving the chamber among all groups (P>0.05).After anesthesia induction,the heart rate and blood pressure of the experimental group were higher than those of the control group (P<0.05).Compared with group P,the success rate of sedation was lower,the effective time of sedation was longer,and the incidence of intraoperative somatic reaction and coughing was higher in group R1 (P<0.05),the incidence of intraoperative hypoxemia and hypotension was decreased in group R2 (P<0.05),the success rate of sedation was increased,the effective time of sedation was decreased,and the incidence of body movement reaction,coughing,hypoxemia and hypotension was decreased in group R3 (P<0.05).Conclusion:Remimazolam 0.3 mg/kg combined with sufentanil has higher efficacy and safety in painless ultrasound gastroscopy.