丙泊酚、环泊酚、瑞马唑仑3种不同药物协同右美托咪定在无痛胃肠镜联合检查中的应用效果

The Application Effect of Propofol,Cipropofol,and Remimazolam Three Different Drugs Synergized with Dexmedetomidine in Painless Gastroenteroscopy Combination Examination

目的研究丙泊酚、环泊酚、瑞马唑仑3种不同药物协同右美托咪定在无痛胃肠镜联合检查中的应用效果。方法前瞻性随机选取长沙市中医医院于2023年8—12月收治的150例无痛胃肠镜联合检查的成人患者为研究对象,按照随机数表法分为丙泊酚组(P组,丙泊酚联合0.5µg/kg右美托咪定)、环泊酚组(C组,环泊酚联合0.5µg/kg右美托咪定)、瑞马唑仑组(R组,瑞马唑仑联合0.5µg/kg右美托咪定),各50例。评估3组患者在麻醉诱导前(T1)、胃镜通过喉部(T2)、肠镜通过肛门(T3)、肠镜到达回盲部(T4)、检查结束时(T5)的生命体征,并记录麻醉指标、不良事件发生率及临床疗效。结果3组患者T1时的经皮血氧饱和度(Oxygen Saturation,SpO_(2))、心率(Heart Rate,HR)、平均动脉压(Mean Arterial Pressure,MAP)比较,差异无统计学意义(P均>0.05);R组T2~T5的HR、MAP高于P组及C组,P组、C组T2的SpO_(2)低于T1,T2~T5的HR、MAP低于T1,R组T2的SpO_(2)低于T1,T2~T4的HR、MAP低于T1,差异有统计学意义(P均<0.05)。R组的苏醒时间、离室时间短于P组和C组,差异有统计学意义(P均<0.05)。R组和C组的低血压(0、6.00%)、头晕(2.00%、4.00%)、呼吸抑制(0、2.00%)的发生率明显低于P组(24.00%、20.00%、18.00%),差异有统计学意义(χ^(2)=17.333、12.296、15.643,P均<0.05)。结论环泊酚、瑞马唑仑协同右美托咪定应用于无痛胃肠镜联合检查患者疗效明显,且安全性较好,其中瑞马唑仑协同右美托咪定对患者循环呼吸影响波动小,能够缩短苏醒时间和离室时间。

Objective To study the application of dexmedetomidine with propofol,cipropofol and remimazolam in painless gastroenteroscopy.Methods A total of 150 adult patients with painless gastrointestinal endoscopy admitted to Changsha Hospital of Traditional Chinese Medicine from August to December 2023 were prospective randomly selected as the research objects.According to the random number table method,they were divided into propofol group(group P,propofol combined with 0.5µg/kg dexmedetomidine),propofol group(group C,cipropofol combined with 0.5µg/kg dexmedetomidine),and remazolam group(group R,Remimazolam combined with 0.5µg/kg dexmedetomidine),50 cases in each group.The vital signs of the three groups of patients at before anesthesia induction(T1),gastroscopy through the throat(T2),colonoscopy through the anus(T3),colonoscopy to the ileocecal(T4)and at the end of the examination(T5)were evaluated,and the anesthesia indexes,the incidence of adverse events and the clinical efficacy were recorded.Results There were no statistically significant difference in percutaneous oxygen saturation(SpO_(2)),heart rate(HR),and mean arterial pressure(MAP)among three groups of patients at T1(all P>0.05).HR and MAP at T2-T5 in group R were higher than those in group P and group C,SpO_(2) at T2 in group P and group C was lower than that at T1,HR and MAP at T2-T5 were lower than those at T1,SpO_(2) at T2 in group R was lower than that at T1,HR and MAP at T2-T4 were lower than those at T1,the differences were statistically significant(all P<0.05).The recovery time and departure time of group R were shorter than those of group P and group C,and the differences were statistically significant(both P<0.05).The incidences of hypotension(0,6.00%),dizziness(2.00%,4.00%)and respiratory depression(0,2.00%)in group R and group C were significantly lower than those in group P(24.00%,20.00%,18.00%),and the differences were statistically significant(χ^(2)=17.333,12.296,15.643,all P<0.05).Conclusion The application of cipropofol and remimazolam synergized with dexmedetomidine in patients with painless combined gastroenteroscopy has obvious efficacy and better safety,in which remimazolam synergized with dexmedetomidine has little fluctuation in the effect of circulatory and respiratory effects on the patients,and is able to shorten the time of awakening and the time of leaving the room.