[1]李富贵,王 云,马颖才.苯磺酸瑞马唑仑在老年无痛胃肠镜检查中的应用及对患者血流动力学的影响[J].陕西医学杂志,2022,51(2):222-225.[doi:DOI:10.3969/j.issn.1000-7377.2022.02.022]
　LI Fugui,WANG Yun,MA Yingcai.Application of remimazolam besylate in elderly patients with painless gastrointestinal endoscopy and its effect on hemodynamics[J].,2022,51(2):222-225.[doi:DOI:10.3969/j.issn.1000-7377.2022.02.022]
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苯磺酸瑞马唑仑在老年无痛胃肠镜检查中的应用及对患者血流动力学的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年2期
页码:
222-225
栏目:
药物与临床
出版日期:
2022-02-05

文章信息/Info

Title:
Application of remimazolam besylate in elderly patients with painless gastrointestinal endoscopy and its effect on hemodynamics
作者:
李富贵; 王 云; 马颖才
(青海省人民医院,青海 西宁810007)
Author(s):
LI Fugui; WANG Yun; MA Yingcai
(Qinghai Provincial People's Hospital,Xining 810007,China)
关键词:
苯磺酸瑞马唑仑;  阿芬太尼;  无痛胃肠镜;  老年人;  呼吸抑制;  注射痛
Keywords:
Remimazolam besylate;  Alfentanil;  Painless gastrointestinal endoscopy;  Elderly patients;  Respiratory depression;  Injection pain
分类号:
R 614.24
DOI:
DOI:10.3969/j.issn.1000-7377.2022.02.022
文献标志码:
A
摘要:
目的:探索苯磺酸瑞马唑仑在老年无痛胃肠镜检查中的应用价值及对患者血流动力学的影响。方法:选择行无痛胃肠镜检查的老年患者60例,随机分为两组,A组为丙泊酚联合阿芬太尼,B组为苯磺酸瑞马唑仑联合阿芬太尼,每组30例,A组丙泊酚1～2 mg/kg复合阿芬太尼4 μg/kg,B组苯磺酸瑞马唑仑7 mg复合阿芬太尼4 μg/kg; 睫毛反射消失后开始内镜检查,如术后发生体动反应分别追加丙泊酚0.2～0.5 mg/kg或苯磺酸瑞马唑仑3 mg; 记录患者麻醉诱导前(T1)、胃镜通过喉部(T2)、肠镜时(T3)、肠镜通过肝区(T4)、检查结束时(T5)时的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2),起效时间、苏醒时间、离室时间以及不良反应(包括呛咳、体动反应、呼吸抑制、注射痛、谵妄等)的发生率。结果:两组间比较:MAP在T2时点,HR在T2、T3、T4时点比较差异有统计学意义(均P<0.05),SpO2两组比较各时点差异无统计学意义(P>0.05)。组内比较:A组MAP T1时点比T2、T3、T4时点降低差异有统计学意义(P<0.05),T2时点比T3、T4、T5时点升高差异有统计学意义(均P<0.05),T3时点比T5时点升高差异有统计学意义(P<0.05); B组MAP T1时点比T2、T3、T4、T5时点降低差异有统计学意义(均P<0.05); A组HR T1与T2、T3、T4比较差异有统计学意义(均P<0.05),T2比T4、T5升高差异有统计学意义(均P<0.05),T3比T5升高差异有统计学意义(P<0.05)。B组HR T1比T2、T3下降差异有统计学意义(P<0.05)。两组SpO2 在T1时点与T2、T3、T4、T5比较均升高,差异有统计学意义(均P<0.05)。B组起效时间较A组长,B组苏醒时间较A组短,两组差异均有统计学意义(均P<0.05),两组患者离室时间比较差异无统计学意义(P>0.05)。B组的呛咳发生率较A组高,A组呼吸抑制、嗜睡、头晕、恶心呕吐、谵妄发生率较B组高,两组比较差异均有统计学意义(均P<0.05)。结论:苯磺酸瑞马唑仑联合阿芬太尼用于老年患者无痛胃肠镜的麻醉时循环稳定、呼吸抑制较轻,苏醒完全且不良反应发生率低。
Abstract:
Objective:To explore the application of remimazolam besylate in elderly patients with painless gastrointestinal endoscopy and its effect on hemodynamics.Methods:Sixty elderly patients who underwent painless gastrointestinal endoscopy were randomly divided into two groups,30 cases in each group.Group A was treated with propofol 1 to 2 mg/kg and alfentanil 4 μg/kg,and group B was treated with remimazolam besylate 7 m g and alfentanil 4 μg/kg.After the eyelash reflex disappeared,the endoscopy was started.If the body movement occurred after the operation,propofol 0.2 to 0.5 mg/kg or remimazolam besylate 3 mg were added.MAP,HR,SpO2 before anesthesia(T1),gastroscopy through the larynx(T2),at the beginning of colonoscopy(T3),colonoscopy through the liver area(T4),awakening(T5),onset time,wake-up time,departure time and adverse reactions(including choking,body movement reaction,respiratory depression,injection pain,delirium,etc.)were recorded.Results:There was significant difference in MAP at T2 and HR at T2,T3 and T4 between two groups(all P<0.05),but there was no significant difference in SpO2 at each time point(all P>0.05).In group A,MAP at T1 was significantly lower than that at T2,T3 and T4,and MAP at T2 was significantly higher than that at T3,T4 and T5,and MAP at T3 was significantly higher than that at T5 (all P<0.05).In group B,MAP at T1 was significantly lower than that at T2,T3,T4 and T5 (all P<0.05).In group A,there was significant difference between HR at T1 and that at T2,T3 and T4,and HR at T2 was significantly higher than that at T4 and T5,and HR at T3 was significantly higher than that at T5 (all P<0.05).In group B,HR at T1 was significantly lower than that at T2 and T3 (all P<0.05).In two groups,SpO2 at T1 was significantly higher than that at T2,T3,T4 and T5 (all P<0.05).The onset time of group B was longer than that of group A,and the wake-up time of group B was shorter than that of group A(all P<0.05).There was no significant difference in departure time between the two groups(P>0.05).The incidence of choking cough in group B was higher than that in group A,and the incidences of respiratory depression,drowsiness,dizziness,nausea,vomiting and delirium in group A were higher than those in group B(all P<0.05).Conclusion:remimazzolam besylate combined with alfentanil for painless gastrointestinal endoscopy in elderly patients has stable circulation,mild respiratory inhibition,complete wake-up and low incidence of adverse reactions.

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备注/Memo

备注/Memo:
基金项目:青海省消化疾病临床医学研究项目(2019-SF-L5)
更新日期/Last Update: 2022-02-09