瑞马唑仑复合阿芬太尼用于无痛胃镜检查术患者麻醉效果的评价  

Anesthetic efficacy of remiazolam combined with alfentanil in patients undergoing painless gastroscopy

作　　者：徐畅 何龙[1] 任娟娟[1] 周俊飞[1] 吕蕴琦[1] 李莉[1] Xu Chang;He Long;Ren Juanjuan;Zhou Junfei;Lyu Yunqi;Li Li(Department of Anesthesiology and Perioperative Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院麻醉与围术期医学部,郑州450000

出　　处：《中华麻醉学杂志》2022年第10期1215-1218,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价瑞马唑仑复合阿芬太尼用于无痛胃镜检查术的麻醉效果。方法择期行无痛胃镜检查术患者400例,性别不限,年龄20~64岁,BMI 18~30 kg/m2,ASA分级Ⅰ或Ⅱ级。采用随机数字表法分为2组(n=200):瑞马唑仑复合阿芬太尼组(RA组)和丙泊酚复合阿芬太尼组(PA组)。采用深吸气法进行吸氧去氮,RA组依次静脉注射阿芬太尼7μg/kg和瑞马唑仑0.2 mg/kg,PA组依次静脉注射阿芬太尼7μg/kg和丙泊酚1.5 mg/kg。术中发生体动反应时,RA组静脉注射瑞马唑仑2.5 mg,PA组静脉注射丙泊酚0.5 mg/kg,15 min内追加3次仍有体动反应则定义为麻醉失败。记录麻醉成功情况、镇静药物显效时间、胃镜检查时间、苏醒时间、围术期不良反应发生情况和内镜医生-麻醉医生-患者的满意度评分(视觉模拟评分法)。结果与PA组比较,RA组术中低血压发生率(6.2%/14.0%)、心动过缓发生率(6.2%/19.0%)、呼吸抑制发生率(3.1%/8.0%)、注射痛发生率(2.1%/30.0%)和术后恶心发生率(6.3%/25.0%)、乏力发生率(7.8%/14.0%)降低,术中呃逆发生率(8.3%/1.0%)及患者满意度评分升高(P<0.05);2组镇静成功率、镇静药物显效时间、胃镜检查时间、苏醒时间、麻醉医生-内镜医生的满意度评分和术后呕吐、头晕、嗜睡发生率差异无统计学意义(P>0.05)。结论相对于无痛胃镜检查术常规麻醉而言,瑞马唑仑(0.2 mg/kg)复合阿芬太尼(7μg/kg)麻醉具有一定的优化效果。Objective To evaluate the anesthetic efficacy of remiazolam combined with alfentanil in the patients undergoing painless gastroscopy.Methods A total of 400 patients of both sexes,aged 20-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists Physical Status classificationⅠorⅡ,scheduled for elective painless gastroscopy,were divided into 2 groups(n=200 each)using the computer-generated random numbers:remimazolam combined with alfentanil group(group RA)and propofol combined with alfentanil group(group PA).All subjects inhaled oxygen and were denitrogenated by deep inhalation.Alfentanil 7μg/kg and remimazolam 0.2 mg/kg were intravenously injected in group RA,and alfentanil 7μg/kg and propofol 1.5 mg/kg were intravenously injected in group PA.When body movement occurred during operation,remimazolam 2.5 mg was intravenously injected in group RA,propofol 0.5 mg/kg was intravenously injected in group PA,and anesthesia was defined as failure when there was still body movement after 3 times of additional injection within 15 min.The success of anesthesia,effective time of sedatives,time of gastroscopy,emergence time,perioperative adverse reactions,and satisfaction score of endoscopic surgeons-anesthesiologists-patients were assessed using visual analog scale score.Results Compared with group PA,the incidence of hypotension(6.2%/14.0%),bradycardia(6.2%/19.0%),respiratory depression(3.1%/8.0%),injection pain(2.1%/30.0%),postoperative nausea(6.3%/25.0%),fatigue(7.8%/14.0%)was significantly decreased,and the incidence of hiccup(8.3%/1.0%)and patient′s satisfaction score were increased in group RA(P<0.05).There was no significant difference between the two groups in the success rate of sedation,effective time of sedatives,time of gastroscopic examination,emergence time,satisfaction scores of anesthesiologists-endoscopic surgeons,and incidence of postoperative vomiting,dizziness,and lethargy(P>0.05).Conclusions Compared with conventional anesthesia for painless gastroscopy,remiazolam(0.2 mg/kg

关 键 词：苯二氮[艹卓]类 阿芬太尼 二异丙酚 麻醉 静脉 胃镜检查 

分 类 号：R614[医药卫生—麻醉学]