摘要
目的:探究甲苯磺酸瑞马唑仑(瑞马唑仑)复合瑞芬太尼或阿芬太尼在无痛胃肠镜检查中的麻醉效果及安全性。方法:2022年3月至8月于新乡市中心医院行无痛胃肠镜检查的患者264例,分为瑞芬太尼组和阿芬太尼组(各132例),分别于静脉注射瑞芬太尼(0.25μg/kg)或阿芬太尼(4μg/kg)后缓慢静脉注射瑞马唑仑(0.3 mg/kg)。比较两组麻醉效果和麻醉相关指标(麻醉起效时间、苏醒时间、离室时间、定向力恢复时间),麻醉给药前(T_(0))、胃镜过喉部(T_(1))、肠镜开始(T_(2))、肠镜过肝区(T_(3))、唤醒时(T_(4))的血氧饱和度、平均动脉压、心率,以及术中术后不良反应发生情况。结果:阿芬太尼组和瑞芬太尼组麻醉优良率分别为97.7%和97.0%,两组间差异无统计学意义(P>0.999)。两组患者麻醉起效时间、离室时间、定向力恢复时间差异无统计学意义(P>0.05),但瑞芬太尼组苏醒时间短于阿芬太尼组(P<0.05)。从T_(0)到T_(4),两组患者血氧饱和度、心率均先降低后逐步回升,但T_(1)、T_(2)、T_(3)、T_(4)阿芬太尼组心率高于瑞芬太尼组,T_(1)、T_(2)、T_(4)阿芬太尼组血氧饱和度高于瑞芬太尼组(P<0.05)。阿芬太尼组不良反应发生率(10.6%)低于瑞芬太尼组(22.7%)(P=0.008)。结论:瑞马唑仑复合阿芬太尼或瑞芬太尼用于无痛胃肠镜检查麻醉效果均较好,复合阿芬太尼对血液循环影响更小,不良反应更少,更安全。
Aim:To investigate the effect and safety of remimazolam tosylate(remimazolam)combined with remifentanil or alfentanil in painless gastroscopy.Methods:A total of 264 patients undergoing painless gastroscopy at Xinxiang Central Hospital from March 2022 to August 2022 were allocated into 2 groups,remifentanil group and alfentanil group(132 cases in each group),and remimazolam(0.3 mg/kg)was slowly injected intravenously after administration of remifentanil(0.25μg/kg)or alfentanil(4μg/kg),respectively.The anesthetic effect,related indicators(anesthetic onset time,awakening time,departure time,directional force recovery time),blood oxygen saturation(SpO 2),mean arterial pressure(MAP),heart rate(HR)at preoperative anesthesia(T_(0)),endoscopic laryngoscopy(T_(1)),endoscopic initiation(T_(2)),endoscopic liver region(T_(3)),and awakening(T_(4)),and adverse reactions were compared between the 2 groups.Results:The overall excellent and good rate for alfentanil group and remifentanil group was 97.7%and 97.0%,and there was no significant difference between the 2 groups in overall excellent and good rate,the onset time of anesthesia,departure time,or the recovery time of directional force(P>0.05).The recovery time of remifentanil group was shorter than that of alfentanil group(P<0.05).From time T_(0)to T_(1),the SpO 2 and HR were decreased first and then increased gradually in both groups;at time T_(1),T_(2),T_(3)and T_(4),HR in alfentanil group was higher than that in remifentanil group,and at time T_(1),T_(2)and T_(4),SpO 2 in alfentanil group was higher than that in remifentanil group(all P<0.05).The incidence of adverse reactions in alfentanil group(10.6%)was lower than that(22.73%)in remifentanil group(P<0.05).Conclusion:Remimazolam combined with alfentanil or remifentanil in painless gastroscopy has satisfactory anesthetic effect,but remimazolam combined with alfentanil has less impact on blood circulation,fewer adverse reactions,and higher safety.
作者
杨建功
赵利芳
孟瑞霞
周霞
杨燕
刘德智
YANG Jiangong;ZHAO Lifang;MENG Ruixia;ZHOU Xia;YANG Yan;LIU Dezhi(Department of Anesthesia and Perioperative Medicine,Xinxiang Central Hospital(the Fourth Clinical College of Xinxiang Medical College),Xinxiang,Henan 453000;Respiratory Intensive Care Unit,Xinxiang Central Hospital(the Fourth Clinical College of Xinxiang Medical College),Xinxiang,Henan 453000)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2023年第3期433-437,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
中青年医学研究专项基金(Z-2018-35-2101)。
