瑞马唑仑对无痛肠镜检查患者血流动力学的影响

目的评估瑞马唑仑对无痛肠镜检查患者血流动力学的影响。方法选取择期行无痛肠镜检查术的患者80例,美国麻醉医师协会(ASA)Ⅰ~Ⅲ级,年龄18~65岁,随机分为2组:P组为丙泊酚组(n=40),R组为瑞马唑仑组(n=40)。麻醉诱导P组静脉注射丙泊酚1.5 mg/kg,R组静脉注射瑞马唑仑7 mg,两组均静脉注射舒芬太尼0.1μg/kg,术中若患者出现体动、明显的吞咽动作等情况,追加药物,维持镇静深度MOAA/S评分≤3。记录两组不同时点平均动脉压(MAP)、心率(HR)、脉氧饱和度(SpO_(2))、呼吸频率(RR),记录两组间血压和心率的波动值;记录麻醉诱导时间、肠镜检查时间、苏醒时间以及PACU留观时间;记录术中低血压、低氧饱和度、气道梗阻例数。结果在麻醉后T2、T3、T5时间点P组患者MAP低于R组(P<0.05),瑞马唑仑组患者麻醉期间血压、心率波动值低于丙泊酚组(P<0.05);与P组相比,R组苏醒时间和PACU留观时间缩短(P<0.05),两组麻醉诱导时间和肠镜检查时间差异无统计学意义;与P组相比,R组患者低血压发生率降低(P<0.05)。结论瑞马唑仑在无痛肠镜检查手术中的应用,可保证患者血流动力学稳定,且镇静效果理想。

Objective To evaluate the effect of remazolam on hemodynamics in patients undergoing painless colonoscopy.Methods In this prospective and randomized controlled study,eighty patients aged 18~65 years with American Society of Anesthesiologists(ASA)Grade I~III were scheduled for a colonoscopy.All patients were randomly assigned into the group P and the group R(n=40 each).Patients in the P group received an intravenous injection of propofol 1.5 mg/kg and patients in the R group were induced by an intravenous injection of remazolam 7 mg.Both groups received an intravenous injection of sufentanil 0.1μg/kg.Additional drugs were added to maintain sedation depth MOAA/S score≤3 in case of movement and obvious swallowing.Mean arterial pressure,heart rate,SpO_(2),and respiratory rate were recorded in two groups at different time points.The time of anesthesia induction,colonoscopy,awakening,and PACU observation were also recorded.The case number of hypotension,hypoxia saturation,and airway obstruction during the operation were observed.Results The mean arterial pressure in the group P was lower than that in group R at T2,T3,and T5 time points after anesthesia(P<0.05).The fluctuation values of blood pressure and heart rate in the group R during anesthesia were significantly lower than those in the group P(P<0.05).Compared with the P group,the emergence time and discharge time in the R group were shorter(P<0.05),and there was no significant difference in induction time and colonoscopy time between the two groups.Compared with the group P,the incidence of hypotension in group R was lower(P<0.05).Conclusion The application of remazolam in painless colonoscopy can ensure the stability of hemodynamics and the sedative effect is ideal.