ERCP麻醉中艾司氯胺酮结合苯磺酸瑞马唑仑的作用及对循环功能的影响

Effects of esketamine combined with Remazolam besylate on circulatory function in ERCP anesthesia

目的探讨内镜下逆行胰胆管造影(ERCP)麻醉应用艾司氯胺酮结合苯磺酸瑞马唑仑的价值。方法选取个旧市人民医院2021年10月-2023年10月行ERCP患者180名,以随机法将其分为观察组和对照组,每组各90名。对照组予以丙泊酚+右美托咪定麻醉,观察组予以艾司氯胺酮+苯磺酸瑞马唑仑麻醉。对比两组麻醉效果、疼痛程度等。结果观察组麻醉总有效率98.89%较对照组的91.11%高(P<0.05);术后6h、12h和24h,观察组视觉模拟评分法(VAS)评分较对照组低(P<0.05);麻醉后,两组心率、平均动脉压、呼吸频率和血氧饱和度均有所降低,观察组降低幅度小于对照组,且均较对照组高(P<0.05);观察组起效、苏醒及离室时间较对照组短(P<0.05)。结论ERCP麻醉应用艾司氯胺酮结合苯磺酸瑞马唑仑可提高麻醉效果,缓解术后疼痛,改善呼吸和循环功能,改善麻醉情况,麻醉安全性理想,值得临床推广。

Objective To investigate the value of esketamine combined with remazolam besylate under endoscopic retrograde cholangiopancreatography(ERCP).Methods 180 patients receiving ERCP in our hospital from October 2021 to October 2023 were randomly divided into observation group and control group,with 90 patients in each group.The control group was anesthetized with propofol+dexmedetomidine,and the observation group was anesthetized with esketamine+remazolam besylate.The anesthetic effect and pain degree were compared between the two groups.Results The anesthetic effect of observation group was 98.89%higher than that of control group,which was 91.11%(P<0.05).At 6h,12h and 24h after operation,the VAS score of the observation group was lower than that of the control group(P<0.05).After anesthesia,the heart rate,mean arterial pressure,respiratory rate and blood oxygen saturation of both groups were decreased,and the reduction of observation group was smaller than that of control group,and higher than that of control group(P<0.05).The time of onset,recovery and departure from the chamber in the observation group was shorter than that in the control group(P<0.05).Conclusion Esketamine combined with remazolam besylate in anesthesia of ERCP can improve anesthesia effect,relieve postoperative pain,improve respiratory and circulatory function,and improve anesthesia condition.The safety of anesthesia is ideal and worthy of clinical promotion.