苯磺酸瑞马唑仑与丙泊酚在无痛结肠镜检查中的应用效果比较

Comparison of the effect of Remimazolam Besylate and Propofol in painless colonoscopy

目的观察注射用苯磺酸瑞马唑仑在无痛结肠镜检查中的应用效果。方法选取2021年9月至2022年2月联勤保障部队第九〇〇医院收治的60例行无痛结肠镜检查的患者作为研究对象,按照随机数字表法分为丙泊酚(P)组和瑞马唑仑(R)组,每组各30例。患者检查前均静脉给予舒芬太尼0.1μg/kg,3 min后P组给予丙泊酚2 mg/kg静脉麻醉,R组给予苯磺酸瑞马唑仑0.2 mg/kg静脉麻醉,记录麻醉诱导前(T0)、诱导后(睫毛反射消失)1 min(T1)、结肠镜进入肛门时(T2)、结肠镜经过肝曲时(T3)、结肠镜到达回盲部时(T4)的平均动脉压(MAP)、心率(HR)、和脉搏血氧饱和度(SpO2);记录患者起效时间、苏醒时间、离室时间及不良反应发生情况。结果R组T1~T4的MAP、HR高于P组,T1的SpO2高于P组,差异有统计学意义(P<0.05)。R组的苏醒时间与离室时间短于P组,差异有统计学意义(P<0.05);而两组的起效时间比较,差异无统计学意义(P>0.05)。R组的低氧血症、低血压、嗜睡、头晕、注射痛的发生率低于P组,差异有统计学意义(P<0.05)。两组术中体动、术后恶心呕吐的发生率比较,差异无统计学意义(P>0.05)。结论苯磺酸瑞马唑仑用于无痛结肠镜检查与丙泊酚具的临床药效相似,但苯磺酸瑞马唑仑对患者循环呼吸影响波动小,苏醒时间和离室时间均短于丙泊酚,在安全性方面具有一定的优势。

Objective To observe the effect of Remimazolam Besylate and Propofol in painless colonoscopy.Methods Sixty patients who underwent painless colonoscopy from September 2021 to February 2022 at the 900th Hospital of the Joint Logistic Support Force were selected as the research objects,and they were divided into the Propofol(P)group and Remimazolam Besylate(R)group according to the random number table method,with 30 cases in each group.Patients were given Sufentanil 0.1μg/kg intravenously before the examination,Propofol 2 mg/kg intravenously in P group and Remimazolam Besylate 0.2 mg/kg intravenously in R group.Mean arterial pressure(MAP),heart rate(HR),and pulse oxygen saturation(SpO2)were recorded at the time before induction of anesthesia(T0),1 min after induction(disappearance of eyelash reflex)(T1),when the colonoscope entered the anus(T2),when the colonoscope passed the hepatic flexure(T3),the colonoscope reached the ileocecal region(T4).The onset time,recovery time,time out of the room and the occurrence of adverse reactions were recorded.Results The MAP and HR of T1-T4 in R group were higher than those in P group,and the SpO2 of T1 was higher than that in P group,with statistical significance(P<0.05).The recovery time and exit time of R group were shorter than those of P group,and the difference was statistically significant(P<0.05).There was no significant difference in the onset time between the two groups(P>0.05).The incidence of hypoxemia,hypotension,lethargy,dizziness and injection pain in R group were lower than that in P group,with statistical significances(P<0.05).There were no significant difference in the incidence of intraoperative body movement and postoperative nausea and vomiting between the two groups(P>0.05).Conclusion The clinical efficacy of Remimazolam Besylate for painless colonoscopy is similar to that of Propofol,but the effect of Remimazolam Besylate on patients'circulatory breathing is less fluctuating,and the time to wake up and time to leave the room are shorter than that of propofol,which has certain advantages in terms of safety.