苯磺酸瑞马唑仑联合阿芬太尼用于无痛胃镜的临床效果观察

Clinical effect observation of remidazolam besylate combined with alfentanil in painless gastroscopy

目的 探讨苯磺酸瑞马唑仑联合阿芬太尼用于无痛胃镜的临床疗效。方法 选取2022年1—3月宁津县人民医院舒适化诊疗中心进行无痛胃镜检查的患者204例,根据随机数字表法分为A、B两组,A组使用苯磺酸瑞马唑仑联合阿芬太尼(101例),B组使用丙泊酚联合舒芬太尼(103例)。比较两组患者诱导前及诱导后1 min、3 min、5 min、10 min、15 min的MAP、HR、SpO2、呼吸频率(respiratory rate,RR),麻醉诱导时间、总检查时间、苏醒时间,患者满意度、麻醉医师与内镜医师的满意度,诱导前和术后2 min Ramsay评分及不良反应发生率。结果 204例患者中,男88例,女116例,平均年龄(53.2±12.7)岁。与B组相比,A组诱导后1 min、3 min、5 min、10 min、15 min的MAP、HR、RR、SpO2的值均较高,麻醉诱导时间、总检查时间、苏醒时间均较短,术后2 min的Ramsay评分较低,差异均有统计学意义(P<0.05)。A组和B组不良反应发生率分别为10.89%和16.50%,差异无统计学意义(P>0.05)。结论 相比丙泊酚联合舒芬太尼,无痛胃镜中使用苯磺酸瑞马唑仑联合阿芬太尼后,患者术中血流动力学及呼吸功能更稳定,诱导时间更快,总检查时间和苏醒时间更短,麻醉效果可靠,安全度高。

Objective To explore the clinical efficacy of remimazolam besylate combined with alfentanil in painless gastroscopy.Methods A total of 204 patients who underwent painless gastroscopy in the Comfort Diagnosis and Treatment Center of Ningjin County People's Hospital from January to March 2022 were selected,and were divided into two groups according to the random number table method.Group A was treated with remimazolam besylate combined with alfentanil(101 cases),group B was treated with propofol combined with sufentanil(103 cases).The MAP,HR,SpO2and respiratory rate(RR) were observed before and after induction at 1 min,3 min,5 min,10 min and 15 min.Anesthesia induction time,total examination time,recovery time,patient satisfaction,anesthesiologist and endoscopicist satisfaction,Ramsay score before induction and 2 minutes after operation and incidence of adverse reactions were recorded and compared between the two groups.Results There were 88 males and 116 females among the 204 patients,with an average age of(53.2 ± 12.7) years.Compared with group B,the MAP,HR,RR and SpO2in group A were higher at 1 min,3 min,5 min,10 min and 15 min after induction,respectively,the anesthesia induction time,total examination time and recovery time in group A were shorter,and the Ramsay score was lower at 2 min after operation,the differences were statistically significant(all P<0.05).The incidence of adverse reactions in group A and group B was 10.89% and 16.50%,respectively,and the difference was not significant(P>0.05).Conclusions Compared with propofol combined with sufentanil,the use of remimazolam benesulfonate combined with alfentanil in painless gastroscopy has more stable intraoperative hemodynamics and respiratory function,with faster induction time,shorter total examination time and shorter recovery time.The anesthesia effect is reliable and safe.