瑞马唑仑复合丙泊酚在老年患者无痛肠镜检查中的应用效果  

Effect of Remazolam Combined with Propofol in Elderly Patients Undergoing Painless Colonoscopy

作　　者：张慧伟[1] 吴勇 周仕斌 ZHANG Huiwei;WU Yong;ZHOU Shibin(Department of Anesthesiology,Leshan People's Hospital,Leshan,Sichuan 614000,China)

机构地区：[1]乐山市人民医院麻醉科,四川乐山614000

出　　处：《临床误诊误治》2023年第9期136-141,共6页Clinical Misdiagnosis & Mistherapy

基　　金：四川省国际医学交流促进会项目(L20200509003)。

摘　　要：目的 探究瑞马唑仑复合丙泊酚对行无痛肠镜检查的老年患者镇静程度、血流动力学及安全性的影响。方法 选取2021年5月—2022年10月行无痛肠镜检查的老年患者140例,按麻醉方法分为研究组和对照组,每组70例。研究组采用瑞马唑仑复合丙泊酚麻醉,对照组采用舒芬太尼复合丙泊酚麻醉。比较2组麻醉情况、围术期不同时间点镇静程度、血流动力学指标、氧化应激指标水平及肠镜检查时间、苏醒情况、检查后至离院时间,记录不良反应发生情况。结果 研究组麻醉起效时间、肠镜检查时间、苏醒时间、苏醒后观察室停留时间、检查后至离院时间短于对照组,麻醉医生对麻醉满意度评分高于对照组,丙泊酚用量少于对照组(P<0.01)。研究组肠镜置入即刻(T1)、肠镜操作5 min(T2)、检查结束时(T3)改良警觉镇静评分低于对照组(P<0.01);研究组T1、T2、T3时点心率、收缩压、舒张压低于对照组(P<0.01);研究组T2时点血清超氧化物歧化酶、过氧化氢酶、丙二醛水平低于对照组(P<0.01)。研究组不良反应发生率[7.14%(5/70)]与对照组[14.29%(10/70)]比较差异无统计学意义(P>0.05)。结论 瑞马唑仑复合丙泊酚对行无痛肠镜检查的老年患者镇静程度高、麻醉效果好,可抑制氧化应激反应,维持血流动力学稳定,且安全性高。Objective To investigate the effects of Rimazolam combined with Propofol on the degree of sedation,haemodynamics and safety in elderly patients undergoing painless colonoscopy.Methods A total of 140 elderly patients who underwent painless colonoscopy from May 2021 to October 2022 were selected and divided into research group(n=70)and control group(n=70)according to anesthesia method.The research group was anesthetised with Remazolam combined with Propofol,and the control group was anesthetised with Sufentanil combined with Propofol.Anesthesia,sedation degree at different time points during perioperative period,hemodynamic indexes,oxidative stress indexes,time of colonoscopy,recovery time and interval between examination and discharge time of the two groups were compared,and adverse reactions were recorded.Results Onset time of anesthesia,time of colonoscopy,recovery time,length of stay in observation room after recovery,and interval between examination and discharge time were shorter in the research group than in the control group.The score of anesthesiologist's satisfaction with anesthesia was higher than that in the control group,and the dosage of propofol was lower than that in the control group(P<0.01).The modified observer's assessment of alert/sedation score(MOAA/S)of the research group was lower than that of the control group immediately after colonoscopy(T1),at 5 min after colonoscopy(T2),and at the end of examination(T3)(P<0.01).The heart rate,systolic blood pressure and diastolic pressure of the research group at T1,T2 and T3 were lower than those of the control group(P<0.01).The serum levels of superoxide dismutase,catalase,and malondialdehyde in the research group were lower than those in the control group at T2(P<0.01).There was no significant difference in the incidence of complications between the research group and the control group[7.14%(5/70)vs.14.29%(10/70)](P>0.05).Conclusion Remazolam combined with Propofol has good sedative and anesthetic effect in elderly patients undergoing painless colono

关 键 词：瑞马唑仑 丙泊酚 肠镜检查 麻醉和镇痛 血流动力学 丙二醛 超氧化物歧化酶 过氧化氢酶 

分 类 号：R614[医药卫生—麻醉学]