瑞马唑仑在老年肥胖患者无痛胃镜检查中的应用效果

Effects of remimazolam on the efficacy in elderly obese patients undergoing painless gastroscopy

目的评估瑞马唑仑在老年肥胖患者接受无痛胃镜检查术中的效果及对术后早期神经行为认知状态的影响。方法选择无痛胃镜检查的老年患者80例,男41例,女39例,年龄≥65岁,BMI 30~40 kg/m^(2),采用随机数字表将患者分为两组,每组40例。丙泊酚组(P组)静脉注射丙泊酚1.5 mg/kg;瑞马唑仑组(R组)静脉注射瑞马唑仑0.15 mg/kg。待患者MOAA/S≤1分时进行胃镜操作。记录给药前、胃镜检查后1、3 min、检查结束时和清醒后5 min的MAP、HR和SpO_(2);镇静时间、操作时间、恢复时间和不良反应发生情况;在患者清醒后5 min时进行神经行为认知状态检查(NCSE)。结果与P组比较,胃镜检查后1、3 min,R组MAP和SpO_(2)明显升高,镇静时间、恢复时间明显缩短,不良反应发生率明显降低,清醒后5 min时NCSE记忆力测试正确率和计算能力筛查通过率明显升高(P<0.05)。结论瑞马唑仑用于老年肥胖患者行无痛胃镜检查能在短时间内使患者达到需要的镇静深度,血流动力学更稳定,不良反应更少,不会降低术后早期神经行为认知状态。

Objective To evaluate the effects of remimazolam on the efficacy and early cognitive function in elderly obese patients undergoing painless gastroscopy.Methods Eighty patients undergoing painless gastroscopy,41 males and 39 females,aged≥65 years,BMI 30-40 kg/m^(2),were randomly divided into 2 groups with 40 cases in each group.The propofol group(group P)was intravenously injected with propofol 1.5 mg/kg;the remimazolam group(group R)was intravenously injected with remimazolam 0.15 mg/kg.Gastroscopy was performed when the patient's MOAA/S≤1.MAP,HR,and SpO_(2) were recorded before anesthesia,1 min and 3 min after gastroscopy,the end of gastroscopy,and 5 min after awakening.The patient's sedation time,operation time,recovery time and the incidence of adverse reactions were recorded.The neurobehavioral cognitive status examination(NCSE)was performed 5 minutes after the patients woke up.Results Compared with group P,1 min and 3 min after gastroscopy,MAP and SpO_(2) were significantly higher;the sedation time,the recovery time,and the incidence of adverse reactions were significantly lower;the correct rate of memory test and the passed rate of computational ability screening in NCSE were significantly higher in group R(P<0.05).Conclusion Remimazolam for elderly obese patients undergoing painless gastroscopy can achieve the required depth of sedation quickly,has stable hemodynamics and fewer adverse reactions,and does not affect early neurobehavioral cognitive status.