甲苯磺酸瑞马唑仑在老年患者胃镜检查术中的临床应用

Clinical Application of Remimazolam Tosilate in Elderly Patients with Gastroscopy

目的:探讨甲苯磺酸瑞马唑仑用于胃镜老年患者对其血流动力学及安全性的影响。方法:选取本院2021年6月至10月行胃镜检查的老年患者80例,采用随机数字表法随机分为2组,对照组(C组)和试验组(R组),每组40例。C组患者采用丙泊酚镇静,R组患者采用瑞马唑仑镇静。记录两组患者入室时(T0)、镇静药给药结束后(T1)、进镜时(T2)、进镜后2 min (T3)、出镜时(T4)、出镜后30 min (T5)六个时间点心率(Heart Rate, HR)、血压(Blood Pressure, BP)、呼吸频率(Respiratory Rate, RR)、脉搏血氧饱和度(Pulse Oxygen Saturation, SpO2)、脑电双频谱指数(Bispectral Index, BIS)、改良警觉/镇静评分(Modified Observer’s Assessment of Alert/Sedation, MOAA/S);记录两组患者手术操作时间、出镜后至苏醒时间、定向力恢复时间;记录两组患者术中注射痛、低血压、心动过缓、呼吸抑制发生率;记录两组患者术后恶心呕吐、术后躁动、头晕、术中知晓发生率及满意度。结果:R组患者的BP、HR、RR、SpO2、BIS在T1、T2、T3、T4四个时间点均高于C组患者(P < 0.05);与C组比较,R组患者苏醒时间和定向力恢复时间缩短(P < 0.05);与C组比较,R组患者术中注射痛、低血压、呼吸抑制、心动过缓发生率均降低(P < 0.05);与C组比较,R组患者术后烦躁、恶心呕吐、头晕发生率均降低,满意度升高(P < 0.05)。结论:瑞马唑仑在老年患者胃镜中应用有利于患者血流动力学平稳,且安全性较高,苏醒快,不良反应少。

Objective: To investigate the effects of hemodynamics and safety with remimazolam in elderly pa-tients with gastroscopy. Methods: Eighty elderly patients who underwent gastroscopy in our hospi-tal from June to October 2021 were selected and randomly divided into 2 groups by random num-ber table method: control group (group C) and experimental group (group R), with 40 cases in each group. Patients in group C were sedated by propofol, and patients in group R were sedated by remazolam. The Heart Rate (HR), Blood Pressure (BP), Respiratory Rate (RR), Pulse Oxygen Satura-tion (SpO2), Bispectral Index (BIS), Modified Observer’s Assessment of Alert/Sedation (MOAA/S) of the two groups were recorded at the time of entry (T0), after the end of sedative administration (T1), at the time of admission (T2), 2min after admission (T3), at the time of exit (T4) and 30 min after exit (T5) were recorded. The time of operation, the time from emergence to recovery and the recovery time of orientation were recorded in the two groups. The incidence of intraoperative injec-tion pain, hypotension, bradycardia and respiratory depression were recorded in the two groups. Postoperative nausea and vomiting, postoperative agitation, dizziness, the incidence of intraopera-tive awareness and satisfaction were recorded in the two groups. Results: BP, HR, RR, SpO2 and BIS in group R were higher than those in group C at T1, T2, T3 and T4 (P < 0.05). Compared with group C, the recovery time of patients in group R was shortened (P < 0.05). Compared with group C, the in-cidence of intraoperative injection pain, hypotension, respiratory depression and bradycardia in group R were all decreased (P < 0.05). Compared with group C, the incidence of postoperative irri-tability, nausea, vomiting and dizziness in group R was decreased, and satisfaction was increased (P < 0.05). Conclusion: Remimazolam is suitable for elderly patients with stable hemodynamics, high safety, quick recovery and few adverse reactions in gastroscopy.