瑞马唑仑联合纳布啡在无痛胃肠镜检查中的麻醉效果

Anesthetic effect of remazolam combined with nalbuphine in painless gastroenteroscopy

目的观察瑞马唑仑联合纳布啡在无痛胃肠镜检查中的麻醉效果。方法选取2022年1月至12月在吕梁市兴县人民医院进行无痛胃肠镜检查的患者95例,按照用药方法分为丙泊酚联合纳布啡组(PN组,47例)和瑞马唑仑联合纳布啡组(RN组,48例)。PN组采用丙泊酚联合纳布啡麻醉,RN组采用瑞马唑仑联合纳布啡麻醉。比较2组患者麻醉开始前、结束时和苏醒时的呼吸频率、心率、血氧饱和度(SpO_(2))及平均动脉压(MAP)水平,记录2组麻醉起效时间及苏醒时间,统计2组患者不良反应发生情况。结果PN组麻醉结束时和苏醒时RR、SpO_(2)、MAP水平低于麻醉开始前,心率水平高于麻醉开始前,差异有统计学意义(P<0.05)。RN组麻醉结束时和苏醒时RR、MAP水平低于麻醉开始前,差异有统计学意义(P<0.05)。RN组麻醉结束时心率低于PN组,SpO_(2)高于PN组,差异有统计学意义(P<0.05);RN组麻醉结束时和苏醒时呼吸频率、MAP高于PN组,差异有统计学意义(P<0.05)。RN组麻醉起效时间(1.7±0.2)min,长于PN组(1.2±0.3)min,差异有统计学意义(P<0.05);RN组术后苏醒时间为(4.6±1.6)min,短于PN组的(6.2±1.8)min,差异有统计学意义(P<0.05)。RN组患者的注射痛、低血压、呼吸抑制、头晕发生率分别为4%、13%、6%、17%,低于PN组的32%、40%、19%、38%,差异有统计学意义(P<0.05);2组恶心呕吐发生率比较,差异无统计学意义(P>0.05)。结论无痛胃肠镜检查中应用瑞马唑仑复合纳布啡麻醉的呼吸循环稳定效果优于丙泊酚联合纳布啡,不良反应更少,值得推广应用。

Objective To observe the clinical effect of Remazolam combined with nbuphine in painless gastroenteroscopy.Methods A total of 95 patients who underwent painless gastroenteroscopy between January 2022 and December 2022 in Xingxian People′s Hospital were enrolled in the study.These patients were divided into two groups based on the method of medication:the propofol combined with nalbuphine group(PN group,47 cases)and the remazolam combined with nalbuphine group(RN group,48 cases).In the PN group,patients re-ceived a combination of propofol and nalbuphine,while in the RN group,patients received a combination of rema-zolam and nalbuphine.The respiratory rate(RR),heart rate(HR),oxygen saturation(SpO_(2)),and mean arterial pressure(MAP)levels of both groups before,during,and after anesthesia were compared.Additionally,the onset time of anesthesia and recovery time for both groups were recorded.Furthermore,the occurrence of adverse reac-tions in both groups were analyzed.Results At the end of anesthesia and during recovery,patients in the PN group exhibited significantly lower RR,SpO_(2),and MAP levels compared to their pre-anesthesia values,while HR levels were significantly higher(P<0.05).Conversely,in the RN group,RR and MAP levels were also significantly lower at the end of anesthesia and during recovery compared to preanesthesia levels(P<0.05).Notably,at the end of anesthesia,patients in the RN group had lower HR levels and higher SpO_(2)levels compared to the PN group,with statistically significant differences(P<0.05).Additionally,RR and MAP levels in the RN group were higher than those in the PN group at the end of anesthesia and during recovery,with statistically significant differences observed(P<0.05).Regarding anesthetic onset,the RN group exhibited a significantly longer time of(1.7±0.2)minutes compared to the PN group′s(1.2±0.3)minutes(P<0.05).However,the RN group had a significantly short-er postoperative recovery time of(4.6±1.6)minutes compared to the PN group′s(6.2±1.8)minutes(P<0.05).Fur-thermore,the incidence rates of adverse reactions in the RN group were lower than those in the PN group.Specifi-cally,the RN group had significantly lower rates of injection pain(4%vs 32%),hypotension(13%vs 40%),respi-ratory depression(6%vs 19%),and dizziness(17%vs 38%)compared to the PN group,with statistically signifi-cant differences(P<0.05).No significant difference was observed between the two groups in terms of nausea and vomiting incidence(P>0.05).Conclusion In painless gastroenteroscopy,the anesthetic combination of rema-zolam and nalbuphine exhibits superior respiratory cycle stability compared to the use of propofol in con-junction with nalbuphine.Moreover,the former regimen elicits fewer adverse reactions,making it a highly recom-mendable anesthetic option worthy of widespread utilization.