瑞马唑仑对胃肠镜检查术患者胃肠运动功能的影响  

Effects of remimazolam on gastrointestinal motor function in patients undergoing gastrointestinal endoscopy

作　　者：杨天意 巩霞[2] 隋炎炎 张丽娜[1] 刘冰[1] 王明山[1] 孙立新[1] 时飞[1] 袁阳 张高峰[1] Yang Tianyi;Gong Xia;Sui Yanyan;Zhang Lina;Liu Bing;Wang Mingshan;Sun Lixin;Shi Fei;Yuan Yang;Zhang Gaofeng(Department of Anesthesiology,Qingdao Municipal Hospital,Qingdao 266071,China;Department of Hospital Infection-Control,Qingdao Municipal Hospital,Qingdao 266071,China)

机构地区：[1]青岛市市立医院麻醉科,青岛266071 [2]青岛市市立医院院感科,青岛266071

出　　处：《中华麻醉学杂志》2023年第1期80-83,共4页Chinese Journal of Anesthesiology

基　　金：2021年山东省医学会临床科研专项资金(YXH2021ZX011);山东省自然科学基金(ZR2021MH365)。

摘　　要：目的评价瑞马唑仑对胃肠镜检查术患者胃肠运动功能的影响。方法选择本院2022年5月至2022年8月行胃肠镜检查术的门诊患者262例,年龄18~64岁,BMI 18~28 kg/m^(2),ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为2组(n=131):瑞马唑仑组(R组)和丙泊酚组(P组)。R组静脉注射瑞马唑仑0.20~0.25 mg/kg,P组静脉注射丙泊酚1.5~2.0 mg/kg,待患者改良警觉/镇静评分≤3分时开始胃肠镜检查术。于胃肠道准备前空腹时、胃肠镜检查前、离开PACU时采用ELISA法检测血清胃动素和胃泌素浓度,记录内镜医师对患者的肠蠕动评级,记录检查期间低血压和低氧血症的发生情况以及PACU期间腹胀、腹痛、恶心和呕吐的发生情况。结果与P组比较,R组肠蠕动评级升高,离开PACU时血清胃动素和胃泌素浓度升高,检查期间低血压和低氧血症发生率降低,PACU期间腹胀发生率降低(P<0.05)。结论相比丙泊酚,瑞马唑仑对胃肠镜检查术患者兴奋性胃肠激素分泌的抑制作用轻,利于胃肠动力恢复。Objective To evaluate the effects of remimazolam on gastrointestinal motor function in the patients undergoing gastrointestinal endoscopy.Methods A total of 262 American Society of Anesthesiologists Physical Status classificationⅠorⅡpatients,aged 18-64 yr,with body mass index of 18-28 kg/m^(2),scheduled for elective gastrointestinal endoscopy from May 2022 to August 2022,were divided into 2 groups(n=131 each)using a random number table method:remimazolam group(group R)and propofol group(group P).The patients in group R received intravenous remimazolam 0.20-0.25 mg/kg,and patients in group P received intravenous propofol 1.5-2.0 mg/kg.The gastrointestinal endoscopy was performed when the patients′Modified Observer′s Assessment of Alertness/Sedation scores≤3.During fasting before gastrointestinal preparation,before gastrointestinal endoscopy and while leaving the post-anesthesia care unit(PACU),the concentrations of serum motilin and gastrin were measured by enzyme-linked immunosorbent assay,the intestinal peristalsis rating assessed by the endoscopist during the examination was recorded,the occurrence of hypotension and hypoxemia during the examination and occurrence of abdominal distension,abdominal pain,and nausea and vomiting during stay in PACU were recorded.Results Compared with group P,the intestinal peristalsis rating was significantly increased,the serum motilin and gastrin concentrations were increased while leaving PACU,the incidence of hypotension and hypoxemia was decreased during the examination,and the incidence of abdominal distention was decreased during stay in PACU in group R(P<0.05).Conclusions Remimazolam has a milder inhibitory effect on secretion of gastrointestinal hormones than propofol in the patients undergoing gastrointestinal endoscopy and is helpful for the recovery of gastrointestinal motility.

关 键 词：苯二氮类 胃镜检查 胃肠活动 

分 类 号：R614[医药卫生—麻醉学]