苯磺酸瑞马唑仑与丙泊酚用于无痛内镜下逆行性胰胆管造影的镇静效果及安全性分析  

Sedative effect and safety analysis of remazolam besylate and propofol on endoscopic retrograde cholangio-pancreatography

作　　者：谭丹丹 李娟 安珂 余婉秋 朱昭琼 Tan Dandan;Li Juan;An Ke;Yu Wanqiu;Zhu Zhaoqiong(Department of Anesthesia,the Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563099,China;Early Clinical Research Ward of Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563099,China)

机构地区：[1]遵义医科大学附属医院麻醉科,贵州遵义563099 [2]遵义医科大学附属医院早期临床研究病房,贵州遵义563099

出　　处：《遵义医科大学学报》2023年第11期1088-1093,共6页Journal of Zunyi Medical University

基　　金：贵州省卫生健康委科学技术基金资助项目(NO:gzwkj2023-398)。

摘　　要：目的苯磺酸瑞马唑仑与丙泊酚用于内镜下逆行性胰胆管造影(ERCP)诊疗镇静的有效性和安全性的比较。方法选择行无痛ERCP诊疗的患者116例,随机分为丙泊酚组和苯磺酸瑞马唑仑组(瑞马唑仑组),每组58例。所有患者给予舒芬太尼2 min后注射丙泊酚或苯磺酸瑞马唑仑,待患者MOAA/S评分≤2时行ERCP诊疗,结束后Aldrete评分≥9分返回病房。比较两组患者镇静成功的比例,记录麻醉手术情况、各时间点生命体征变化及不良反应发生情况。结果两组镇静成功的比例无差异。MOAA/S评分≤2分的时间、麻醉时间、ERCP诊疗时间无差异(P>0.05),丙泊酚组苏醒时间短于瑞马唑仑组(P<0.05)。苏醒时丙泊酚组MAP高于瑞马唑仑组(P<0.05),丙泊酚组在给药后2 min、入镜10 min时RR较瑞马唑仑组明显降低(P<0.05),给药后2 min、十二指肠镜置入时SpO_(2)较瑞马唑仑组明显降低(P<0.05)。丙泊酚组注射痛、SpO_(2)下降、呼吸暂停、低血压发生率高于瑞马唑仑组(P<0.05)。结论苯磺酸瑞马唑仑和丙泊酚均可为ERCP诊疗提供良好的镇静效果,但苯磺酸瑞马唑仑相对于丙泊酚对呼吸循环的影响更小,不良反应发生率更低,更适用于ERCP诊疗的临床镇静。Objective Comparison of efficacy and safety of remimazolam besylate and Propofol for sedation in endoscopic retrograde cholangio-pancreatography(ERCP)treatment.Methods A total of 116 patients receiving painless ERCP were randomly divided into propofol group and remimazolam besylate group(remimazolam group),with 58 cases in each group.All patients were given sufentanil for 2 min and then injected with propofol or remimazolam besylate.After MOAA/S score≤2,ERCP diagnosis and treatment were performed,and Aldrete score≥9 was returned to the ward.The proportion of successful sedation between the two groups was compared,and the anesthesia operation,changes of vital signs at each time point and the occurrence of adverse reactions were recorded.Results There was no difference in the proportion of successful sedation between the two groups.MOAA/S score≤2 points,anesthesia time,ERCP treatment time had no difference(P>0.05).The propofol group was shorter than remimazolam group in recovery time(P<0.05).MAP of propofol group was higher than remimazolam group(P<0.05).Compared with the propofol group,HR in the remimazolam group was increased 2 min after administration to the end of diagnosis and treatment(P<0.05),while RR and SpO_(2)in the propofol group were significantly decreased 2 min after administration compared with remimazolam group(P<0.05).The incidence of injection pain,SpO_(2)decrease,apnea and hypotension in propofol group was higher than remimazolam group(P<0.05).Conclusion Remimazolam besylate and propofol both provided good sedative effects for ERCP treatment.However,compared with propofol,remimazolam besylate had less influence on respiratory circulation and lower incidence of adverse reactions,so it is more suitable for clinical sedation in ERCP diagnosis and treatment.

关 键 词：苯磺酸瑞马唑仑 丙泊酚 内镜下逆行性胰胆管造影 手术室外麻醉 镇静 

分 类 号：R453.9[医药卫生—治疗学]