甲苯磺酸瑞马唑仑与丙泊酚在儿童无痛胃镜检查中的比较  

Remimazolam versus Propofol for children undergoing painless gastroscopy

作　　者：白雪[1] 罗昊 黄雅莹 黄俊祥 谭永红 宋兴荣[1] 李碧莲 BAI Xue;LUO Hao;HUANG Yayin;HUANG Junxiang;TAN Yonghong;SONG Xingrong;LI Bilian(Department of Anesthesiology,Guangzhou Women and Children's Medical Center,Guangzhou 510120,China)

机构地区：[1]广州医科大学广州市妇女儿童医疗中心麻醉科,广州510120

出　　处：《实用医学杂志》2023年第19期2529-2533,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81901385);广州市科技项目(编号:2023B03J1388)。

摘　　要：目的比较甲苯磺酸瑞马唑仑和丙泊酚在儿童无痛胃镜检查的有效性和安全性。方法收集年龄4~9岁,ASA分级Ⅰ-Ⅱ级,BMI 18~30 kg/m2,拟在静脉全身麻醉下行无痛胃镜检查患者129例。采用随机数字表法分为2组:甲苯磺酸瑞马唑仑组(R组)与丙泊酚组(P组)。麻醉诱导使用舒芬太尼0.2µg/kg和盐酸戊乙奎醚0.01 mg/kg。R组给予甲苯磺酸瑞马唑仑0.5 mg/kg,P组给予丙泊酚3 mg/kg。记录两组无痛胃镜的首次用药后成功率、心率、血压、脉搏氧饱和度、镇静评分、Narcotrend指数以及入睡时间、苏醒时间和不良反应。结果R组和P组无痛胃镜首次用药成功率分别为82.8%和90.8%,差异无统计学意义(P>0.05)。R组患者在入镜时和退镜后的Narcotrend指数分别是(84.7±10.8)和(86.4±4.3),明显高于P组的(58.9±13.2)和(66.2±5.0)(P<0.05)。R组患者苏醒时间为(14.2±6.9)min,明显低于P组(23.8±6.7)min(P<0.05)。R组和P组的注射痛发生率分别为10.9%和52.3%,差异有统计学意义(P<0.05)。其余入睡时间和不良反应发生率均差异无统计学意义(P>0.05)。结论甲苯磺酸瑞马唑仑和丙泊酚均能安全有效地应用于儿童无痛胃镜检查,但甲苯磺酸瑞马唑仑苏醒更迅速且注射痛发生率更低。Objective To compare the efficacy and safety of remimazolam vs propofol for children undergoing painless gastroscopy.Methods A total of 129 children aged 4~9 years,ASAⅠ-Ⅱ,BMI 18-30 kg/m^(2),scheduled for painless gastroscopy under intravenous general anesthesia were divided into two groups by random number table method:remimazolam group(R group)and propofol group(P group).Anesthesia was induced with sufentanil 0.2μg/kg and penehyclidine hydrochloride 0.01 mg/kg.The patients in R group was given 0.5 mg/kg remimazolam and in P group was given 0.3 mg/kg propofol.The success rate of completing painless gastroscopy,heart rate,blood pressure,pulse oxygen saturation,sedation score,narcotrend index were recorded.The onset time,recovery time of orientation and adverse reactions were observed.Results The success rate of sedation in R group and P group was 82.8%and 90.8%respectively,with no statistically difference(P>0.05).At the time of endoscopic insertion and the end of endoscopic operation,the narcotrend index value of R group was 84.7±10.8,86.4±4.3,respectively,which was significantly higher than that of P group(58.9±13.2 and 66.2±5.0)(P<0.05).The postoperative recovery time of R group was(14.2±6.9)min,which was lower than that of P group(23.8±6.7)min(P<0.05).The incidence of injection pain in R group and P group was respectively 10.9%and 52.3%,with statistically significant difference(P<0.05).And the other adverse reactions were not statistically significant(P>0.05).Conclusion Both remimazolam and propofol could be safely and effectively used gastroscopy for children,and remimazolam made patients wake up quickly with a lower incidence of injection pain.

关 键 词：瑞马唑仑 丙泊酚 儿童 无痛胃镜 

分 类 号：R614[医药卫生—麻醉学]