瑞马唑仑在老年患者无痛胃肠镜检查中的应用  

Application of remimazolam in elderly patients undergoing painless gastrointestinal endoscopy

作　　者：苏丹 梁涛 陈超然 季中华 张微 姚秀秀 王颖林[1] SU Dan;LIANG Tao;CHEN Chao-ran;JI Zhong-hua;ZHANG Wei;YAO Xiu-xiu;WANG Ying-lin(Department of Anesthesiology,Shanghai East Hospital,Tongji University School of Medicine,SHANGHAI 200120,China)

机构地区：[1]同济大学附属东方医院麻醉科,上海200120

出　　处：《中国新药与临床杂志》2024年第6期442-445,共4页Chinese Journal of New Drugs and Clinical Remedies

基　　金：白求恩·围术期镇痛镇静研究项目(BCF-RE-VSQZTZJ-202011-059)。

摘　　要：目的评价瑞马唑仑用于老年患者无痛胃肠镜检查的效果。方法选择拟行无痛胃肠镜检查的老年患者,随机分为2组。对照组麻醉诱导方案为舒芬太尼0.1μg·kg^(-1)+丙泊酚1.5 mg·kg^(-1),检查过程中丙泊酚追加剂量为每次0.5 mg·kg^(-1);试验组的给药方案为舒芬太尼0.1μg·kg^(-1)+瑞马唑仑0.15 mg·kg^(-1)诱导,检查过程中瑞马唑仑每次追加剂量为首剂的1/3。记录麻醉过程中患者心率、呼吸频率、平均动脉压、血氧饱和度,以及诱导、苏醒、出室时间,观察注射痛、低氧血症、低血压等不良反应的发生情况。结果最终441例患者纳入分析,对照组225例,试验组116例。给药后5、10 min,试验组平均动脉压高于对照组,差异有显著意义(P<0.05)。试验组诱导、苏醒和出室时间分别为(41.8±4.3)s、(5.7±4.4)和(10.2±6.5)min,对照组分别为(32.6±2.7)s、(6.6±3.9)和(12.9±7.4)min,试验组诱导时间长于对照组,苏醒和出室时间短于对照组,均有显著差异(P<0.05)。与对照组相比,试验组注射痛(54.2%vs.2.3%)、低血压(16.4%vs.6.9%)和低氧血症(19.6%vs.14.8%)发生率显著降低(P<0.05)。结论瑞马唑仑用于老年患者无痛胃肠镜检查安全有效,具有苏醒快、不良反应发生率低等优点。AIM To evaluate the effects of remimazolam on painless gastroenteroscopy in elderly patients.METHODS The aged patients scheduled for painless gastroenteroscopy were enrolled and randomly divided into 2 groups.The anesthesia induction regimen of the control group was sufentanil 0.1μg·kg^(-1)+propofol 1.5 mg·kg^(-1),and the additional dose of propofol was 0.5 mg·kg^(-1)each time during the examination.The administration regimen of the experimental group was sufentanil 0.1μg·kg^(-1)+remimazolam 0.15 mg·kg^(-1)induction,and each additional dose of remimazolam was 1/3 of the first dose during the examination.Heart rate,respiratory rate,mean arterial pressure,and blood oxygen saturation during anesthesia were recorded.The time of induction,recovery and exit,and adverse reactions such as injection pain,hypoxemia and hypotension were observed.RESULTS A total of 441 patients were included in the analysis,225 in the control group and 116 in the experimental group.Compared with the control group,the mean arterial pressure of the experimental group was higher than that of the control group at 5 and 10 min after administration,and the difference was significant(P<0.05).The induction,recovery and exit time of the experimental group were(41.8±4.3)s,(5.7±4.4)and(10.2±6.5)min,and those in the control group were(32.6±2.7)s,(6.6±3.9)and(12.9±7.4)min,respectively.The induction time of the experimental group was longer than that of the control group,and the recovery and exit time of the control group were shorter,with significant differences(P<0.05).Compared with the control group,the incidence of injection pain(54.2%vs.2.3%),hypotension(16.4%vs.6.9%)and hypoxemia(19.6%vs.14.8%)in the experimental groups was significantly reduced(P<0.05).CONCLUSION Remimazolam is safe and effective for painless gastroenteroscopy in elderly patients,and has the advantages of fast recovery and low incidence of adverse reactions.

关 键 词：瑞马唑仑 胃镜检查 结肠镜检查 老年人 低血压 

分 类 号：R971[医药卫生—药品]