苯磺酸瑞马唑仑与艾司氯胺酮联合用于ERCP麻醉效果及对循环和呼吸指标的影响  

Anesthesia Effect of Remimazolam Besylate Combined with Esketamine in ERCP and Its Influence on Circulatory and Respiratory Indexes

作　　者：陆阳春[1] 邱琼 王礼伟[1] 陈玲利 柏富友 LU Yangchun;QIU Qiong;WANG Liwei;CHEN Lingli;BAI Fuyou(Huangzhou District People's Hospital of Huanggang City,Huanggang 438000,China;不详)

机构地区：[1]黄冈市黄州区人民医院,湖北黄冈438000

出　　处：《中外医学研究》2023年第1期37-41,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨苯磺酸瑞马唑仑与艾司氯胺酮联合用于内镜下逆行胰胆管造影术(ERCP)麻醉效果及对相关指标的影响。方法:选取2021年2月-2022年2月在黄冈市黄州区人民医院接受ERCP治疗的78例胆道疾病患者,经随机数字表法进行分组。对照组(n=39)ERCP治疗行丙泊酚+右美托咪定麻醉,观察组(n=39)ERCP治疗行艾司氯胺酮+苯磺酸瑞马唑仑麻醉。观察两组镇痛、镇静效果及机体循环和呼吸指标变化情况、术中相关麻醉不良反应发生情况。结果:与对照组比较,观察组警觉/镇静(OAA/S)、躁动(RS)评分均更低(P<0.05);对照组、观察组术后6、12、24 h视觉模拟评分(VAS)评分组内比较,差异均有统计学意义(P<0.001),且观察组术后6、12、24 h VAS评分相比对照组均更低(P<0.05)。麻醉后,两组平均动脉压、心率、呼吸频率、血氧饱和度(SpO_(2))均低于麻醉前,但观察组均高于对照组,差异均有统计学意义(P<0.05)。观察组术中呛咳、心动过缓、低血压、呼吸抑制及SpO_(2)降低发生率相比对照组均更低,差异均有统计学意义(P<0.05)。结论:ERCP治疗中行艾司氯胺酮与苯磺酸瑞马唑仑联合麻醉,能获得良好镇痛、镇静效果,且不会对患者机体循环呼吸状况产生严重影响,患者术中麻醉不良反应发生率明显降低。Objective:To investigate the anesthesia effect of Remimazolam Besylate combined with Esketamine in endoscopic retrograde cholangiopancreatography(ERCP)and its influence on related indexes.Method:A total of 78 patients with biliary tract diseases who treated by ERCP in Huangzhou District People’s Hospital of Huanggang City from February 2021 to February 2022were randomly divided into groups according to random number table method.The control group(n=39)was anesthetized with Propofol+Dexmedetomidine after ERCP,and the observation group(n=39)was anesthetized with Esketamine+Remimazolam Besylate.The analgesic and sedative effects,changes of circulatory and respiratory indexes,and the occurrence of intraoperative adverse anesthetic reactions of two groups were observed.Result:Compared with the control group,the vigilance/sedation(OAA/S)and agitation(RS)scores in the observation group were lower(P<0.05).The visual analogue scale(VAS)scores of the control group and the observation group at 6,12 and 24 h after operation comparison within groups,the differences were statistically significant(P<0.001),and the VAS scores of the observation group at 6,12 and 24 h after surgery were lower than those of the control group(P<0.05).After anesthesia,the mean arterial pressure,heart rate,respiratory rate and blood oxygen saturation(SpO_(2))in two groups were lower than those before anesthesia,but the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The incidence of choking cough,bradycardia,hypotension,respiratory depression and SpO_(2)reduction in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Anesthesia with Esketamine combined with Remimazolam Besylate during ERCP can obtain good analgesic and sedative effects,and don’t have a serious impact on patients’circulatory and respiratory conditions,the incidence of adverse anesthetic reactions during operation is significantly reduced.

关 键 词：胆道疾病 内镜下逆行胰胆管造影术 麻醉 艾司氯胺酮 苯磺酸瑞马唑仑 

分 类 号：R614[医药卫生—麻醉学]