甲苯磺酸瑞马唑仑联合丙泊酚用于老年患者无痛胃肠镜的临床研究  

Clinical study of Remimazolam Tosilate combined with Propofol for painless gastroenteroscopy in elderly patients

作　　者：雷高锋 张伟娜 杨婷婷 王立敏 陈平平 丁淑珍 宋建军 耿鹏程 雷雨昕 LEI Gaofeng;ZHANG Weina;YANG Tingting;WANG Limin;CHEN Pingping;DING Shuzhen;SONG Jianjun;GENG Pengcheng;LEI Yuxin(Department of Anesthesiology,Ningjin County People's Hospital,Shandong Province,Ningjin253400,China)

机构地区：[1]山东省宁津县人民医院麻醉科,山东宁津253400

出　　处：《中国当代医药》2025年第1期12-17,共6页China Modern Medicine

基　　金：山东省医学会科研专项资金项目(YXH2022ZX04241)。

摘　　要：目的探讨甲苯磺酸瑞马唑仑用于老年患者无痛胃肠镜的麻醉安全性与有效性。方法选取宁津县人民医院2023年9月至12月收治的200例接受无痛胃肠镜检查的患者作为研究对象,按照随机数字表法分为RPA组(100例)和PA组(100例)。RPA组依次静脉注射5μg/kg的阿芬太尼、0.1 mg/kg的甲苯磺酸瑞马唑仑和2 mg/s的丙泊酚(0.5~1 mg/kg),PA组则静脉注射相同剂量与速率的阿芬太尼和2 mg/s的丙泊酚(1~2 mg/kg)。比较两组术前与术中不同时间点(麻醉诱导前1 min,诱导后1、3、5、10、15、20、25、30 min)的心率、血氧饱和度、收缩压、脑电双频指数、术中追加丙泊酚的量、麻醉诱导时间、麻醉时间、苏醒时间、诱导期与术后不良反应的发生情况。结果两组诱导前的心率、收缩压、血氧饱和度与脑电双频指数比较,差异无统计学意义(P>0.05)。RPA组诱导后不同时间点的血氧饱和度(诱导后1、3、5、10、15、20、25、30 min)高于PA组,差异有统计学意义(P<0.05),RPA组诱导后的收缩压、心率、血氧饱和度与脑电双频指数与PA组比较,差异无统计学意义(P>0.05)。RPA组与PA组不同时间点的血氧饱和度比较,差异有统计学意义(P<0.05)。RPA组患者的术中追加丙泊酚剂量、苏醒时间和不良反应发生率低于PA组,差异有统计学意义(P<0.05)。两组患者的麻醉时间与麻醉诱导时间比较,差异无统计学意义(P>0.05)。结论相较于阿芬太尼,加用甲苯磺酸瑞马唑仑在无痛胃肠镜检查中对老年患者的呼吸抑制更小,麻醉诱导期不良反应发生率更低,安全性与有效性更好。Objective To investigate the safety and effectiveness of Remimazolam Tosilate in elderly patients with painless gastroenteroscopy.Methods A total of 200 patients receiving painless gastroenteroscopy admitted to Ningjin County People's Hospital from September to December 2023 were selected as the study objects,and they were divided into RPA group(100 cases)and PA group(100 cases)according to random number table method.In RPA group,5μg/kg of Alfentanil,0.1 mg/kg of Remimazolam Tosilate and 2 mg/s of Propofol(0.5 to 1 mg/kg)were injected intravenously,while in PA group,the same dose and rate of Alfentanil and 2 mg/s of Propofol(1 to 2 mg/kg)were injected intravenously.The heart rate,blood oxygen saturation,systolic blood pressure,bifrequency index,intraoperative amount of propofol,induction time,anesthesia time,recovery time,induction period and postoperative adverse reactions of the two groups were compared before and at different time points in surgery(1 min before anesthesia induction,1,3,5,10,15,20,25,30 min after induction).Results There were no significant differences in heart rate,systolic blood pressure,oxygen saturation and dual frequency index before induction between the two groups(P>0.05).Blood oxygen saturation in RPA group at different time points after induction(1,3,5,10,15,20,25,30 min after induction)were higher than those in PA group,and the differences were statistically significant(P<0.05).There were no significant differences in systolic blood pressure,heart rate,blood oxygen saturation and dual frequency index of brain after induction in RPA group were compared with those in PA group(P>0.05).The difference of blood oxygen saturation between RPA group and PA group at different time points was statistically significant(P<0.05).The intraoperative supplemental propofol dose,recovery time and incidence of adverse reactions in RPA group were lower than those in PA group,and the differences were statistically significant(P<0.05).There were no significant differences in anesthesia time and induction t

关 键 词：苯二氮[艹卓]类 阿芬太尼 丙泊酚 甲苯磺酸瑞马唑仑 消化内镜 

分 类 号：R614[医药卫生—麻醉学]