摘要
目的探讨瑞马唑仑复合阿芬太尼麻醉用于肥胖患者无痛胃镜检查的效果。方法选取广东省中山火炬开发区人民医院2022年1月至12月收治的行无痛胃镜检查肥胖患者(体质量指数>32 kg/m^(2))93例,根据麻醉方案的不同分为对照组(45例)和观察组(48例)。对照组患者予丙泊酚复合阿芬太尼麻醉方案,观察组患者予瑞马唑仑复合阿芬太尼麻醉方案。结果观察组患者的苏醒时间为(7.13±1.86)min,显著短于对照组的(7.98±2.14)min(P<0.05);观察组患者的重复给药率为45.83%,显著低于对照组的66.67%(P<0.05);观察组患者检查开始后1 min和3 min、检查结束时、清醒后的平均动脉压、心率、血氧饱和度、呼气末二氧化碳分压、呼吸频率均显著高于对照组(P<0.05);两组患者检查过程中低血压、心率减慢、心率加快的发生率差异显著(62.50%比82.22%,8.33%比44.44%,18.75%比4.44%,P<0.05),检查后腹痛腹胀、谵妄的发生率差异显著(4.17%比17.78%,4.17%比24.44%,P<0.05);观察组的内镜医师、麻醉医师、患者满意度评分均显著高于对照组(P<0.05)。结论瑞马唑仑复合阿芬太尼麻醉能缩短肥胖患者无痛胃镜检查后的苏醒时间,降低重复给药率,维持检查过程中血流动力学稳定,降低检查过程中低血压、心率减慢及检查后腹胀腹痛、谵妄的发生率。
Objective To investigate the effect of remazolam combined with alfentanil anesthesia on painless gastroscopy in obese patients.Methods A total of 93 obese patients(with a body mass index>32 kg/m^(2))examined with painless gastroscopy and admitted to the Zhongshan Torch Development Zone People's Hospital from January to December 2022 were selected and divided into the control group(45 cases)and the observation group(48 cases)according to different anesthesia plans.The patients in the control group were treated with propofol combined with alfentanil anesthesia plan,while the patients in the observation group were treated with remazolam combined with alfentanil anesthesia plan.Results The recovery time in the observation group was(7.13±1.86)min,which was significantly shorter than(7.98±2.14)min in the control group(P<0.05).The repeated administration rate in the observation group was 45.83%,which was significantly lower than 66.67%in the control group(P<0.05).The mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO_(2)),end-expiratory carbon dioxide partial pressure(P_(ET)CO_(2)),and respiratory frequency in the observation group were significantly higher than those in the control group at 1 min and 3 min after examination,at the end of examination,and after awakening(P<0.05).There was a significant difference in the incidence of hypotension,decreased heart rate,and increased heart rate between the two groups during the examination(62.50%vs.82.22%,8.33%vs.44.44%,18.75%vs.4.44%,P<0.05),there was a significant difference in the incidence of abdominal pain and distension,and delirium after examination(4.17%vs.17.78%,4.17%vs.24.44%,P<0.05).The endoscopists,anesthesiologists,and patients'satisfaction scores in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Remazolam combined with alfentanil anesthesia can shorten the recovery time after painless gastroscopy in obese patients,reduce the rate of repeated administration,maintain hemodynamic stability during the examination process,and reduce the incidence of hypotension,decreased heart rate,and the incidence of abdominal distension,pain,and delirium after examination.
作者
代文化
刘玲
石子苑
袁波
曾伟
吴靦
DAI Wenhua;LIU Ling;SHI Ziyuan;YUAN Bo;ZENG Wei;WU Mian(Zhongshan Torch Development Zone People′s Hospital,Zhongshan,Guangdong,China 528411;Nanlang Branch of Zhongshan People′s Hospital Brain Center,Zhongshan,Guangdong,China 528411;Zhongshan Bo′ai Hospital,Zhongshan,Guangdong,China 528403)
出处
《中国药业》
CAS
2023年第21期124-127,共4页
China Pharmaceuticals
基金
广东省卫生健康委员会医学科研基金立项项目[B2021190]
广东省中山市卫生健康委员会资助项目[2022J256]。
关键词
瑞马唑仑
阿芬太尼
肥胖
无痛胃镜检查
镇静效果
remazolam
alfentanil
obesity
painless gastroscopy examination
sedative effect
