瑞马唑仑和丙泊酚复合阿片类镇痛药在ERCP术中的麻醉效果  

Anesthetic Effects of Remimazolam and Propofol Combined with Opioid Analgesics in ERCP Procedures

作　　者：崔向前 侯合玺 CUI Xiangqian;HOU Hexi(Department of Anesthesiology,The Third Provincial Hospital of Shandong,Jinan Shandong 250031)

机构地区：[1]山东省立第三医院麻醉科,山东济南250031

出　　处：《医学临床研究》2024年第10期1523-1525,1529,共4页Journal of Clinical Research

摘　　要：【目的】探讨瑞马唑仑和丙泊酚复合阿片类镇痛药在经内镜逆行胰胆管造影(ERCP)术中的麻醉及镇痛效果。【方法】本院收治的202例接受ERCP术全身麻醉患者,随机分为观察组和对照组,每组101例。对照组在使用舒芬太尼与瑞芬太尼镇痛的基础上联合丙泊酚进行麻醉处理,观察组在对照组的基础上加用瑞马唑仑进行麻醉。观察两组患者入睡、苏醒、离室时间,不同时间点[麻醉开始前(T_(1))、进镜时(T_(2))、手术后5 min(T_(3))、手术结束(T_(4))]的血压、心率、血氧饱和度(SaO_(2))、脑电双频指数(BIS)及术后不良反应发生情况。【结果】观察组入睡、离室时间均短于对照组(P<0.05)。两组T_(2)时收缩压、舒张压、心率、SaO_(2)、BIS值均低于T_(1)时,但观察组各项指标高于对照组(P<0.05);对照组患者T_(3)时、T_(4)时的收缩压、舒张压、心率、SaO_(2)、BIS均高于T_(2)时(P<0.05),T_(4)时高于T_(3)时(P<0.05);观察组T_(3)时的收缩压、舒张压、心率、SaO_(2)均高于对照组(P<0.05)。观察组不良反应总发生率(3.96%)低于对照组(11.88%)(P<0.05)。【结论】瑞马唑仑和丙泊酚复合阿片类镇痛药应用于ERCP术患者中,具有较好的麻醉及镇痛效果,且可降低不良反应发生率,值得临床推广应用。【Objective】To explore the anesthetic and analgesic effects of remimazolam and propofol combined with opioid analgesics in endoscopic retrograde cholangiopancreatography(ERCP)procedures.【Methods】A total of 202 patients undergoing general anesthesia for ERCP in our hospital were randomly divided into the observation group and the control group,with 101 patients in each group.In the control group,anesthesia was administered with propofol in combination with sufentanil and remifentanil for analgesia.In the observation group,remimazolam was added to the anesthetic protocol of the control group.The sleep induction time,wake-up time,and room exit time were observed in both groups.Blood pressure,heart rate,oxygen saturation(SaO_(2)),bispectral index(BIS),and postoperative adverse reactions were recorded at different time points:before anesthesia(T_(1)),during endoscope insertion(T_(2)),5 minutes after the operation(T_(3)),and at the end of the procedure(T 4).【Results】The observation group had shorter sleep induction and room exit times compared to the control group(P<0.05).At T_(2),systolic blood pressure,diastolic blood pressure,heart rate,SaO_(2),and BIS were lower in both groups compared to T_(1),with the observation group showing higher values than the control group(P<0.05).In the control group,systolic and diastolic blood pressure,heart rate,SaO_(2),and BIS were higher at T_(3) and T 4 compared to T_(2)(P<0.05),and these values were higher at T 4 than those at T_(3)(P<0.05).At T_(3),systolic and diastolic blood pressure,heart rate,and SaO_(2) in the observation group were higher than those in the control group(P<0.05).The total incidence of adverse reactions in the observation group(3.96%)was lower than that in the control group(11.88%)(P<0.05).【Conclusion】The combination of remimazolam and propofol with opioid analgesics in ERCP procedures provides effective anesthesia and analgesia.It reduces the incidence of adverse reactions,which makes worthy of clinical application.

关 键 词：胰胆管造影术 内窥镜逆行 瑞马唑仑/治疗应用 二异丙酚/治疗应用 镇痛药 阿片类 麻醉 

分 类 号：R575.624[医药卫生—消化系统]