| 摘要: |
| ［摘要］ 目的 比较瑞马唑仑与丙泊酚联合舒芬太尼在老年患者无痛胃镜检查中的应用效果，及其对恢复质量的影响。方法 招募2022年1月至6月于贵州医科大学附属医院行无痛胃镜检查的老年患者134例，采用随机数字表法将其分为对照组和观察组，每组67例。对照组采用丙泊酚联合舒芬太尼的麻醉方案，观察组采用瑞马唑仑联合舒芬太尼的麻醉方案。比较两组麻醉起效时间、胃镜操作时间、苏醒时间、检查后第1天QoR-15量表评分，以及进入手术室时（T1）、舒芬太尼开始给药时（T2）、瑞马唑仑/丙泊酚开始给药时（T3）、下镜时（T4）、下镜后3 min（T5）、下镜后5 min(T6)、退镜后（T7）的心率（HR）、呼吸频率（RR）、脉搏血氧饱和度（SpO2）、平均动脉压（MAP）。比较两组不良反应发生情况。结果 检查后第1天，观察组QoR-15量表总分显著高于对照组（P<0.05）；在QoR-15量表的5个维度中，观察组疼痛度、身体舒适度和身体独立度的评分高于对照组，情绪状态评分低于对照组，差异有统计学意义（P<0.05）。两组心理支持度评分比较差异无统计学意义（P>0.05）。在T4～T7时间点，观察组MAP水平显著高于对照组（P<0.05）。在T4～T6时间点，观察组SpO2水平均显著高于对照组（P<0.05）。两组各观测时间点HR、RR水平比较差异无统计学意义（P>0.05）。两组胃镜操作时间、麻醉起效时间比较差异无统计学意义（P>0.05）。观察组较对照组苏醒更快，差异有统计学意义（P<0.05）。观察组使用血管活性药物、药物追加次数>1次的人数比例，以及低血压、呼吸抑制、恶心呕吐、呛咳、头晕、谵妄、注射痛发生率低于对照组，差异有统计学意义（P<0.05）。结论 瑞马唑仑联合舒芬太尼应用于老年无痛胃镜检查患者效果良好，检查中血流动力学稳定，不良反应发生率低，有助于提高患者恢复质量。 |
| 关键词: 瑞马唑仑 丙泊酚 舒芬太尼 老年患者 无痛胃镜 |
| DOI：10.3969/j.issn.1674-3806.2024.09.09 |
| 分类号:R 614 |
| 基金项目:北京弘医医学发展基金会研究基金资助项目（编号：HY20210037-A-07） |
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| Comparison of the application effects of remimazolam and propofol combined with sufentanil in elderly patients undergoing painless gastroscopy and their impacts on recovery quality |
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XU Hechen1, CHEN Yuanyang1, WU Hongqi1, JIANG Ke1,2, ZOU Xiaohua1,2
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1.College of Anesthesiology,Guizhou Medical University, Guiyang 550004, China; 2.Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550000, China
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| Abstract: |
| ［Abstract］ Objective To compare the application effects of remimazolam and propofol combined with sufentanil in elderly patients undergoing painless gastroscopy and their impacts on recovery quality. Methods A total of 134 elderly patients undergoing painless gastroscopy in the Affiliated Hospital of Guizhou Medical University from January 2022 to June 2022 were recruited and divided into control group and observation group by random number table method, with 67 cases in each group. The anesthesia regimen of propofol combined with sufentanil was used in the control group, and the anesthesia regimen of remimazolam combined with sufentanil was used in the observation group. The onset time of anesthesia, time of operating gastroscope, awakening time, Quality of Recovery-15(QoR-15) scale scores on the first day after examination, as well as the heart rate(HR), respiratory rate(RR), pulse oxygen saturation(SpO2) and mean arterial pressure(MAP) at the time of entry into the operating room(T1), at the start time of sufentanil administration(T2), at the start time of remimazolam/propofol administration(T3),at the time when the insertion tube of the gastroscope was being inserted(T4), at the time of 3 minutes after the insertion tube of the gastroscope was inserted(T5), at the time of 5 minutes after the insertion tube of the gastroscope was inserted(T6), and at the time when the insertion tube of the gastroscope was withdrawn(T7) between the two groups. The occurrence of adverse reactions was compared between the two groups. Results On the first day after examination, the total QoR-15 scale scores in the observation group were significantly higher than those in the control group(P<0.05), and among the five dimensions of the QoR-15 scale, the pain scores, physical comfort scores and physical independence scores in the observation group were higher than those in the control group, and the mood state scores in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). There were no significant differences in psychological support scores between the two groups(P>0.05). From the time point of T4 to the time point of T7, the MAP levels in the observation group were significantly higher than those in the control group(P<0.05). From the time point of T4 to the time point of T6, the SpO2 levels in the observation group were significantly higher than those in the control group(P<0.05). There were no significant differences in HR and RR levels between the two groups at each observation time point(P>0.05). There was no significant difference in the time of operating gastroscope and the onset time of anesthesia between the two groups(P>0.05). The observation group woke up faster than the control group, and the difference was statistically significant(P<0.05). The proportion of the patients using vasoactive drugs and the proportion of the patients with drug addition times more than 1, and the incidence rates of hypotension, respiratory depression, nausea and vomiting, choking cough, dizziness, delirium and injection pain in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). Conclusion The application of remimazolam combined with sufentanil shows good effects on the elderly patients undergoing painless gastroscopy, with stable hemodynamics and low incidence of adverse reactions during the examination, which helps to improve the patients′ recovery quality. |
| Key words: Remimazolam Propofol Sufentanil Elderly patient Painless gastroscopy |
