瑞马唑仑复合雷米芬太尼在老年衰弱患者无痛胃镜检查的应用  

Application of remazolam combined with remifentanil in elderly frailty patients undergoing painless gastroscopy

作　　者：冯发美 张扬 桂波 FENG Famei;ZHANG Yang;GUI Bo(Department of Anesthesiology,Second Affiliated Hospital,Nanjing Medical University,Nanjing 210000,CHINA)

机构地区：[1]南京医科大学第二附属医院麻醉科,江苏210000 [2]南京医科大学第一附属医院麻醉科,江苏210000

出　　处：《江苏医药》2023年第12期1266-1269,共4页Jiangsu Medical Journal

摘　　要：目的探讨瑞马唑仑复合雷米芬太尼在老年衰弱患者无痛胃镜检查中的应用效果。方法择期行无痛胃镜检查的老年衰弱患者112例随机均分为两组,在静脉注射雷米芬太尼0.3μg/kg 1 min后,丙泊酚组和瑞马唑仑组分别给予丙泊酚2.0 mg/kg和瑞马唑仑0.3 mg/kg。待改良警觉/镇静评分≤2分时开始胃镜检查。记录两组患者麻醉诱导前(T0)、诱导后1 min(T1)、诱导后3 min(T2)和检查结束(T3)时的MAP、HR和SpO2。评估医师的麻醉满意度,记录患者苏醒时间,观察不良反应发生情况。结果瑞马唑仑组T1~T3时MAP高于丙泊酚组(P<0.05),T2和T3时HR高于丙泊酚组(P<0.05)。瑞马唑仑组麻醉医师的麻醉满意度评分高于丙泊酚组(P<0.05)。瑞马唑仑组患者苏醒时间短于丙泊酚组(P<0.05),低血压和注射痛发生率低于丙泊酚组(P<0.05)。结论瑞马唑仑复合雷米芬太尼应用于老年衰弱患者无痛胃镜检查中的麻醉效果优于丙泊酚复合雷米芬太尼,患者苏醒迅速,不良反应少。Objective To explore the application efficacy of remazolam combined with remifentanil in elderly frailty patients undergoing painless gastroscopy.Methods A total of 112 elderly frailty patients undergoing elective painless gastroscopy were equally randomized into two groups.After intravenous injection of remifentanil 0.3μg/kg for in one minute,group P and group R were given propofol 2.0 mg/kg and remazolam 0.3 mg/kg,respectively.Gastroscopy started when the modified alertness/sedation score was≤2 points.MAP,HR and SpO_2 of the two groups were recorded before induction(T0),one minute(T1)and 3 minutes after induction(T2),and at the end of the examination(T3).The satisfaction score of the operators to anesthesia was evaluated.The awakening time was recorded.The occurrence of adverse reactions was observed.Results MAP at T1 to T3 was higher in group R than that in group P(P<0.05).HR at T2 and T3 was higher in group R than that in group P(P<0.05).The anesthesiologist satisfaction score in group R was higher than that in group P(P<0.05).The awakening time was shorter in group R than that in group P(P<0.05).The incidence rates of hypotension and injection pain were lower in group R than those in group P(P<0.05).Conclusion The anesthetic effect of remazolam combined with remifentanil in elderly frailty patients undergoing painless gastroscopy is better than that of propofol combined with remifentanil with shorter awakening time and fewer adverse reactions.

关 键 词：瑞马唑仑 雷米芬太尼 无痛胃镜 老年 衰弱 

分 类 号：R614[医药卫生—麻醉学]