瑞马唑仑联用舒芬太尼对患者纤维支气管镜检查血流动力学水平与镇静程度的影响分析

Analysis of the Effect of Remimazolam Combined with Sufentanil on He⁃modynamic Levels and Sedation Degree in Patients Undergoing Fiberoptic Bronchoscopy

目的探究瑞马唑仑基础上引入舒芬太尼对患者纤维支气管镜检查中血流动力学水平的影响及镇静程度作用。方法采用便利抽样法选取2022年8月—2023年8月徐州医科大学附属医院收治的80例纤维支气管镜检查患者为研究对象,根据不同麻醉方式分为两组,各40例。对照组使用瑞马唑仑与芬太尼,研究组使用瑞马唑仑与舒芬太尼,对比两组患者血流动力学水平与镇静程度、应激反应指标、应激反应指标和不良反应发生率。结果进镜前,两组患者血流动力学水平与镇静程度比较,差异无统计学意义(P均>0.05)。镜至隆突时,研究组警觉/镇静观察(Observer's Assessment of Alertness/Sedation,OAA/S)评分低于对照组,差异有统计学意义(P<0.05)。检查结束时,两组患者平均动脉压、心率、脑电双频指数水平比较,差异无统计学意义(P均>0.05)。检查前,两组患者应激反应指标比较,差异无统计学意义(P>0.05)。检查后,研究组醛固酮为(40.05±5.21)ng/L、血清血管紧张素Ⅱ为(28.75±4.06)ng/L,均低于对照组的(46.57±5.71)ng/L、(33.62±4.26)ng/L,差异有统计学意义(t=5.335、5.234,P均<0.05)。研究组检查时间、苏醒时间均短于对照组,但组间比较,差异无统计学意义(P均>0.05)。研究组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论纤维支气管镜检查中,在瑞马唑仑基础上引入舒芬太尼可使患者保持平稳的血流动力学水平,降低患者的应激反应与不良反应发生率。

Objective To explore the effect of introducing sufentanil on the hemodynamic level and sedation degree of patients during fiberoptic bronchoscopy on the basis of remimazolam.Methods A total of 80 patients undergoing fiber⁃optic bronchoscopy admitted to the Affiliated Hospital of Xuzhou Medical University from August 2022 to August 2023 were selected as the research objects by convenient sampling method and divided into two groups according to different anesthesia methods,with 40 cases in each group.The control group used remimazolam and fentanyl,while the study group used remimazolam and sufentanil.The hemodynamic levels,sedation degrees,stress response indica⁃tors and incidence of adverse reactions of the two groups of patients were compared.Results Before admission,there was no significant difference in hemodynamic level and sedation degree between the two groups(all P>0.05).The score of Observer's Assessment of Alertness/Sedation(OAA/S)in the study group was lower than that in the control group when bronchoscopy reached the tracheal carina,and the difference was statistically significant(P<0.05).At the end of the examination,there was no significant difference in mean arterial pressure,heart rate and dual-frequency in⁃dex of brain between the two groups(P>0.05).Before examination,there was no significant difference in stress re⁃sponse indexes between the two groups(P>0.05).After examination,the aldosterone and angiotensinⅡlevels in the study group were(40.05±5.21)ng/L and(28.75±4.06)ng/L respectively,which were lower than those in the control group(46.57±5.71)ng/L and(33.62±4.26)ng/L respectively,and the differences were statistically significant(t=5.335,5.234,both P<0.05).The examination time and recovery time of the study group were shorter than those of the control group,but there was no statistical significance between the groups(both P>0.05).The total incidence of adverse reac⁃tions in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion In fiberoptic bronchoscopy,introducing sufentanil on the basis of remimazolam can keep the patient's he⁃modynamic level stable and reduce the patient's stress response and the incidence of adverse reactions.