瑞马唑仑用于肥胖患者无痛结肠镜下肠黏膜切除术的效果分析

Effect of remazolam on painless colonoscopic resection of intestinal mucosa in obese patients

目的探讨瑞马唑仑用于肥胖患者结肠镜下行肠黏膜切除术的镇静效果。方法选取2022年1月至11月于衢州市第二人民医院行无痛肠镜下黏膜切除术的肥胖患者88例,按随机数字法分为观察组和对照组,每组44例。观察组采用瑞马唑仑0.2mg/kg复合布托啡诺0.5mg静脉镇静;对照组采用丙泊酚2.0 mg/kg复合布托啡诺0.5mg静脉镇静。比较两组患者的镇静有效率,术前、术中各时点的呼吸、循环指标、脑电双频指数(bispect ral index,BIS),肠镜治疗时间、术中中断时间、苏醒时间、离室时间及镇静过程中各种不良事件的发生率。结果两组镇静有效率均为100%。观察组患者用药后操作前(T_(1))、肠镜开始10min(T_(2))时刻的呼吸频率、血氧饱和度(peripheral capillary oxygen saturation,SpO_(2))、平均动脉压、心率均高于同时刻的对照组,差异有统计学意义(P<0.01)。观察组术中体动、低血压、低SpO_(2)的发生率及需要实施辅助呼吸的患者比例均低于对照组,差异有统计学意义(P<0.05)。观察组因处理麻醉不良事件致肠镜中断时间短于对照组,差异有统计学意义(P<0.01)。结论瑞马唑仑用于肥胖患者肠镜下黏膜切除术的镇静是有效的,与丙泊酚相比,患者术中的呼吸和循环更稳定,麻醉不良事件发生率低,肠镜操作中断的时间短,安全性更高。

Objective To investigate the sedative effect of remazolam in obese patients undergoing colonoscopic resection of intestinal mucosa.Methods A total of 88 obese patients who underwent painless colonoscopic mucosal resection in the Second People’s Hospital of Quzhou from January to November 2022 were selected and divided into observation group and control group according to random number method,with 44 cases in each group.The observation group was given intravenous sedation with remazolam 0.2mg/kg combined with butorphanol 0.5mg.The control group was given intravenous sedation with propofol 2.0 mg/kg combined with butorphanol 0.5mg.The effective rate of sedation was compared between the two groups.Respiratory index,circulation index,bispect ral index(BIS)at each time point before and during operation;Colonoscopy treatment time,intraoperative interruption time,recovery time and exit time;The incidence of various adverse events during sedation.Results The effective rate of sedation in both groups was 100%.The mean arterial pressure,heart rate,respiratory rate and peripheral capillary oxygen saturation(SpO_(2))of observation group were decreased before treatment(T_(1))and 10 minutes after colonoscopy(T_(2)),but higher than those of control group at the same time,with statistical significance(P<0.01).The incidence of intraoperative body movement,hypotension,low SpO_(2) and the rate of patients requiring assisted breathing in observation group were lower than those in control group,with statistical significance(P<0.05).The interruption time of colonoscopy due to adverse anesthesia events in observation group was shorter than that in control group,and the difference was statistically significant(P<0.01).Conclusion Remazolam is effective for sedation in obese patients undergoing colonoscopic mucosal resection.Compared with propofol,the intraoperative circulation and respiration of patients are more stable,the incidence of anesthesia adverse events is lower,and the duration of interruption of colonoscopy operation is shorter,and the safety is higher.