甲苯磺酸瑞马唑仑在老年患者无痛胃镜检查中的安全性和有效性

Efficacy and safety of remimazolam tosilate in elderly patients undergoing painless gastroscopy

目的探讨甲苯磺酸瑞马唑仑在老年患者无痛胃镜检查中的安全性和有效性。方法154例行无痛胃镜检查老年患者均分为丙泊酚组(P组,丙泊酚1.5 mg/kg+舒芬太尼0.15μg/kg麻醉)和甲苯磺酸瑞马唑仑组(R组,甲苯磺酸瑞马唑仑0.2 mg/kg+舒芬太尼0.15μg/kg麻醉),待观察者警觉性/镇静评估量表(MOAA/S)评分≤1分后行胃镜操作,术中如有体动每次分别追加丙泊酚和甲苯磺酸瑞马唑仑初始剂量的1/3,收集2组患者的一般临床资料[年龄、体质量指数(BMI)、性别、美国麻醉医师协会(ASA)分级、基础性疾病],记录2组患者给药前(T 0)和给药后2 min(T 1)、4 min(T 2)、6 min(T 3)、8 min(T 4)及离院时(T 5)时的收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏血氧饱和度(SpO 2)、呼吸频率(RR)、呼吸抑制率以及有效性指标和安全性指标,观察2组患者的镇静效果和不良反应的情况。结果2组患者一般临床资料比较、差异无统计学意义(P>0.05),MOAA/S评分均达到≤1分、镇静成功率均为100%;用药后R组患者RR<8次/min的发生率较P组降低(P<0.001);R组和P组患者RR<8次/min的最小值及SpO 2最小值比较,差异有统计学意义(P<0.05);R组患者注射痛的例数明显少于P组(P<0.001)。结论甲苯磺酸瑞马唑仑在老年患者无痛胃镜检查中是安全且有效的。

Objective To investigate the safety and efficacy of remimazolam tosilate for painless gastroscopy in elderly patients.Methods One hundred fifty-four elderly patients undergoing painless gastroscopy were evenly divided into a propofol group(P group,propofol 1.5 mg/kg+sufentanil 0.15μg/kg anesthesia)and a remimazolam tosilate group(R group,remimazolam tosilate 0.2 mg/kg+sufentanil 0.15μg/kg anesthesia).Gastroscopy was performed when the Observer's Assessment of Alertness/Sedation(MOAA/S)score was≤1.If movement occurred during the procedure,an additional 1/3 of the initial dose of propofol or remimazolam tosilate was administered.General clinical data,vital signs[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),pulse oximetry saturation(SpO 2),respiratory rate(RR)],rates of respiratory depression,efficacy,and safety indicators were collected and compared between the two groups.Results There was no significant difference in general clinical data between the two groups(P>0.05).The sedation success rate was 100%for both groups.The R group showed a lower rate of RR<8 times/min(P<0.001)and significant differences in the minimum values of RR and SpO 2(P<0.05).The incidence of injection pain was significantly lower in the R group(P<0.001).Conclusion Remimazolam tosilate can be used effectively and safely for painless gastroscopy in elderly patients.