瑞马唑仑复合阿芬太尼用于儿童舒适化胃镜检查的效果

Effects of remimazolam combined with alfentanil used for comfort gastroscopy in children

目的探讨瑞马唑仑复合阿芬太尼在儿童舒适化胃镜检查中的应用效果。方法将80例择期行舒适化胃镜检查的患儿随机均分为2组。麻醉诱导对照组采用丙泊酚3 mg·kg^(-1)+阿芬太尼15μg·kg^(-1),试验组采用瑞马唑仑0.3 mg·kg^(-1)+阿芬太尼15μg·kg^(-1),每种药品静脉注射时间均为30 s,且间隔30 s。在改良警觉/镇静量表(MOAA/S)评分≤3分时开始进镜检查,若进镜失败或诱导后3 min内MOAA/S评分≥4分则定义为诱导失败,对照组追加丙泊酚1 mg·kg^(-1),试验组追加瑞马唑仑0.1 mg·kg^(-1);检查中若出现体动反应,处理同前。观察并记录2组胃镜检查时间、苏醒时间、复苏室停留时间、首次诱导成功和麻醉成功例数、医师和患儿满意度评分以及检查中不良事件发生情况。结果2组患儿检查时间、苏醒时间、复苏室停留时间、首次诱导成功率和麻醉成功率比较,差异均无显著意义(P>0.05)。2组内镜医师满意度评分比较无显著差异(P>0.05),但试验组麻醉医师和患儿满意度评分显著高于对照组(P<0.05)。2组检查中体动、心动过缓和呛咳发生率比较无显著差异(P>0.05),试验组注射痛和低氧血症发生率显著低于对照组(P<0.05)。结论瑞马唑仑复合阿芬太尼用于儿童舒适化胃镜检查安全、有效,且可提高医患满意度、降低不良事件发生率。

AIM To explore the effects of remimazolam combined with alfentanil used for comfort gastroscopy in children.METHODSS Eighty pediatric patients undergoing elective comfort gastroscopy were randomly divided into two groups(40 in each).For anesthesia induction,the patients in control group received propofol 3 mg·kg^(-1)and alfentanil 15μg·kg^(-1),while the patients in trial group received remimazolam 0.3 mg·kg^(-1)and alfentanil 15μg·kg^(-1).The intravenous injection time of each induction drug was 30 s and the interval was 30 s.All patients began gastroscopy when the modified observer alert/sedation scale(MOAA/S)score≤3.If the gastroscopy failed or MOAA/S score≥4 within 3 min after induction,it was defined as induction failure,and the patients were treated with the addition of propofol 1 mg kg^(-1)in the control group and remimazolam O.1 mg·kg^(-1)in the trial group.If a body reaction occurred,the treatment was the same as above.The time for gastroscopy,emergence time,residence time of resuscitation room,number of successful cases of first induction,number of successful anesthesia cases,physician satisfaction scores,pediatric patient satisfaction scores,and intraoperative adverse events were observed and recorded.RESULTS There was no significant difference in time for gastroscopy,emergence time,residence time of resuscitation room,success rate of first induction and anesthesia(P>0.05).There was no significant difference in the satisfaction scores of endoscopic physician between two groups(P>0.05),but the satisfaction scores of anesthesiologists and pediatric patients in the trial group were significantly higher than those in the control group(P<0.05).There was no significant difference between the two groups in the incidence of body reaction,bradycardia and choking cough(P>0.05),but the incidence of injection pain and hypoxemia in the trial group was significantly lower than that in the control group(P<0.05).CONCLUSION Remimazolam combined with alfentanil is safe and effective for pediatric comfort gastroscopy,and it can improve the satisfaction of anesthesiologists and patients and reduce the incidence of adverse events.