甲苯磺酸瑞马唑仑复合瑞芬太尼在老年患者无痛胃镜检查中的应用效果探讨  

Effects of Remazolam Toluenesulfonate Combined with Remifentanil on Painless Gastroscopy in Elderly Patients

作　　者：朱玫 袁志国[2] 姜琳[2] 周媛[1,3] ZHU Mei;YUAN Zhiguo;JIANG Lin;ZHOU Yuan(School of Medicine,Nantong University,Jiangsu Nantong 226019,China;Dept.of Anesthesiology,Taizhou People’s Hospital,Jiangsu Taizhou 225300,China;Dept.of Pain Treatment,Affiliated Hospital of Nantong University,Jiangsu Nantong 226019,China)

机构地区：[1]南通大学医学院,江苏南通226019 [2]泰州市人民医院麻醉科,江苏泰州225300 [3]南通大学附属医院疼痛科,江苏南通226019

出　　处：《中国医院用药评价与分析》2023年第4期412-415,419,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：江苏省卫生健康委科研项目(No.H20190362)。

摘　　要：目的:探讨甲苯磺酸瑞马唑仑复合瑞芬太尼在老年患者无痛胃镜检查中的应用效果。方法:纳入2020年8月至2022年8月于泰州市人民医院内镜中心接受无痛胃镜检查术的老年患者90例,根据随机数字表法分为P组、R1组和R2组。三组患者均先行盐酸瑞芬太尼0.5μg/kg静脉注射;然后P组患者给予丙泊酚1.5 mg/kg静脉注射麻醉,R1组患者给予甲苯磺酸瑞马唑仑0.15 mg/kg静脉注射麻醉,R2组患者给予甲苯磺酸瑞马唑仑0.2 mg/kg静脉注射麻醉。比较三组患者的镇静起效时间、苏醒时间、用药2 min后的改良警觉/镇静量表(MOAA/S)镇静评分及补救镇静次数,于术前(T_(0))、用药1 min后(T_(1))、内镜置入时(T_(2))、检查结束时(T_(3))和麻醉苏醒时(T_(4))记录血流动力学指标[心率(HR)、平均动脉压(MAP)和脉搏氧饱和度(SpO 2)],统计术中及术后不良反应发生情况。结果:与P组相比,R1组、R2组患者镇静起效时间延长,但苏醒时间缩短,差异均有统计学意义(P<0.05),但R1组、R2组患者的差异无统计学意义(P>0.05)。三组患者用药2 min后的MOAA/S镇静评分比较,差异无统计学意义(P>0.05)。R1组、R2组患者补救镇静发生率(追加镇静药物≥1次)、平均药物追加次数高于P组,差异均有统计学意义(P<0.05),但R1组、R2组患者的差异无统计学意义(P>0.05)。R1组、R2组患者T_(1)—T_(4)时的HR、MAP和T_(1)—T_(2)时的SpO 2高于P组,差异均有统计学意义(P<0.05),但R1组、R2组患者的差异无统计学意义(P>0.05)。与P组比较,R1组患者低血压、低氧血症和注射痛的发生率降低,R2组患者注射痛发生率降低,差异均有统计学意义(P<0.05)。结论:0.15 mg/kg甲苯磺酸瑞马唑仑+0.25μg/mg瑞芬太尼用于老年患者无痛胃镜检查,在保证麻醉效果的同时安全性更高。OBJECTIVE:To probe into application effect of remazolam toluenesulfonate combined with remifentanil on painless gastroscopy in elderly patients.METHODS:A total of 90 elderly patients underwent painless gastroscopy in the endoscopy center of Taizhou People’s Hospital from Aug.2020 to Aug.2022 were enrolled and divided into P group,R1 group and R2 group via random number table method.Three groups were firstly given remifentanil hydrochloride 0.5μg/kg intravenously;then the P group was given propofol 1.5 mg/kg intravenously for anesthesia,the R1 group was given remazolam toluenesulfonate 0.15 mg/kg intravenously for anesthesia,and the R2 group wasgiven remazolam toluenesulfonate 0.2 mg/kg intravenously for anesthesia.The sedation onset time,awakening time,modified alertness/sedation scale(MOAA/S)score after 2 minutes of drug administration and the number of remedial sedation were compared among the three groups,the hemodynamic indicators[heart rate(HR),mean arterial pressure(MAP)and pulse oxygen saturation(SpO 2)],were recorded before surgery(T_(0)),at 1 min after administration(T_(1)),at the time of endoscopic insertion(T_(2)),at the end of the examination(T_(3))and at the time of awakening from anesthesia(T_(4)),the incidence of adverse drug reactions during and after surgery were counted.RESULTS:Compared with P group,patients in R1 group and R2 group had longer sedation onset time but shorter awakening time,with statistically significant differences(P<0.05),while the difference between R1 group and R2 group was not statistically significant(P>0.05).There was no statistically significant difference in the MOAA/S sedation scores among the three groups at 2 min after drug administration(P>0.05).The incidence of remedial sedation(additional sedative drugs≥1 time)and the mean number of drug additions were higher in R1 group and R2 group than those in P group,with statistically significant differences(P<0.05),while the difference between R1 group and R2 group was not statistically significant(P>0.05).The HR and MA

关 键 词：无痛胃镜 老年 甲苯磺酸瑞马唑仑 瑞芬太尼 

分 类 号：R971.2[医药卫生—药品]