可唤醒麻醉对肥胖患者无痛胃肠镜不良事件的影响  

Effect of Awake Anesthesia on Adverse Events During Painless Gastrointestinal Endoscopy in Obese Patients

作　　者：于栋娟 韩冰 宋娟娟 姜永伟 YU Dong-juan;HAN Bing;SONG Juan-juan;JIANG Yong-wei(Weihai Hospital of Traditional Chinese Medicine Affiliated to Shandong University of Traditional Chinese Medicine,Weihai,Shandong 264200)

机构地区：[1]山东省中医药大学附属威海市中医院,山东威海264200

出　　处：《中国肛肠病杂志》2025年第1期57-59,共3页Chinese Journal of Coloproctology

基　　金：山东省卫健医疗管理研究中心临床科研专项资金项目(项目类别:科研与人材管理,项目编号:SDWJYJ2022ZLPD01007)。

摘　　要：目的:探究甲苯磺酸瑞马唑仑联合瑞芬太尼实施可唤醒麻醉对肥胖患者无痛胃肠镜不良事件的影响。方法:选择ASA分级Ⅱ~Ⅲ级,择期行无痛胃肠镜检查患者79例,年龄18~60周岁,体重80~120 kg,BMI≥30 kg/m^(2)。采用随机数字表法,分为M组39例和R组40例。M组患者给予咪达唑仑0.02 mg/kg、瑞芬太尼0.2μg/kg诱导,继以双通道恒速泵注咪达唑仑0.04 mg/kg/h、瑞芬太尼6μg/kg/h;R组组患者给予甲苯磺酸瑞马唑仑0.05 mg/kg、瑞芬太尼0.2μg/kg诱导,继以双通道恒速泵注甲苯磺酸瑞马唑仑0.1 mg/kg/h、瑞芬太尼6μg/kg/h。观察麻醉期间、麻醉苏醒后常见的不良事件发生率及其严重程度等。结果:R组患者在麻醉苏醒15 min后发生头晕嗜睡、恶心呕吐以及不良记忆的发生率明显低于M组(P<0.05),R组患者在进镜时的体动程度评分明显低于M组(P<0.05),R组患者苏醒后在麻醉后监测治疗室(PACU)的驻留时间明显短于M组(P<0.05)。结论:实施可唤醒麻醉,R组麻醉效果更好,发生相关不良事件概率更低。Objective To explore the effect of awake anesthesia with remimazolam tosilate combined with remifentanil on adverse events of painless gastrointestinal endoscopy in obese patients.Methods Total 79 patients with ASA gradingⅡtoⅢscheduled for painless gastrointestinal endoscopy were selected,with age ranging from 18 to 60 years old,body weight from 80 to 120 kg,BMI≥30 kg/m^(2).They were divided into group M(n=39)and group R(n=40)by random number table method.Patients in group M were induced with midazolam 0.02 mg/kg and remifentanil 0.2μg/kg,followed by the dual-channel constant-speed infusion of midazolam at 0.04 mg/kg/h and remifentanil at 6μg/kg/h.Patients in group R were induced with remimazolam tosilate 0.05 mg/kg and remifentanil 0.2μg/kg,followed by the dual-channel constant-speed infusion of remimazolam tosilate at 0.1 mg/kg/h and remifentanil at 6μg/kg/h.The incidence and severity of adverse events during anesthesia and after anesthesia recovery were observed.Results The incidence of dizziness,somnolence,nausea,vomiting and adverse memory in group R was significantly lower than that in group M 15 min after anesthesia recovery(P<0.05).The body movement score in group R was significantly lower than that in group M(P<0.05).The length of stay in post-anesthesia care unit(PACU)in group R was significantly shorter than that in group M(P<0.05).Conclusion The awake anesthesia effect of group R is better and the incidence of related adverse events is lower.

关 键 词：无痛胃肠镜 肥胖 可唤醒麻醉 不良事件 

分 类 号：R614[医药卫生—麻醉学]