摘要
目的探讨不同剂量甲苯磺酸瑞马唑仑用于老年患者无痛肠镜检查的镇静程度及对血流动力学的影响。方法选取2020年6月至2021年6月成都市双流区第一人民医院拟择期实施无痛肠镜的患者,筛选美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级、年龄大于60岁,计划接受诊断或治疗性结肠镜检查(治疗程序可能包括止血、切除、消融术、减压、异物取出等)的患者,按照1∶1∶1的比例分为低剂量(0.1 mg/kg甲苯磺酸瑞马唑仑)组(A组,n=65)、中等剂量(0.15 mg/kg甲苯磺酸瑞马唑仑)组(B组,n=70)、高剂量(0.2 mg/kg甲苯磺酸瑞马唑仑)组(C组,n=67)。比较3组患者麻醉过程中有效镇静率、镇静相关不良反应,以及术后苏醒时间和并发症发生情况。结果低剂量组、中剂量组和高剂量组有效镇静率差异无统计学意义(P>0.05)。与低剂量组相比,首次给予甲苯磺酸瑞马唑仑的剂量越大,起效时间越短。高剂量组术后苏醒时间为(1.21±0.66)min,与低剂量组和中剂量组相比时间更短,差异有统计学意义(P=0.034,P=0.014)。镇静药物使用总量与术后苏醒时间的长短无相关性(P<0.05)。高剂量组低血压的发生率明显低于中剂量组,差异有统计学意义(P<0.05)。3组患者心动过缓、心动过速、低氧血症的发生率差异无统计学意义(P>0.05)。结论甲苯磺酸瑞马唑仑用于60岁以上老年患者无痛肠镜的检查,诱导快,苏醒快,对血流动力学的影响小,推荐剂量0.2 mg/kg。
Objective To investigate the sedation degree of different doses of remazolam tosilate in elderly patients with painless colonoscopy and its influence on hemodynamics.Methods The patients with elective painless colonoscopy in this hospital from June 2020 to June 2021 were selected.The patients were screened by the American society of Anesthesiologists(ASA)classⅠ-Ⅱ,age>60 years old and planning to receive the diagnostic or therapeutic colonoscopy(treatment program might include bleeding,resection,ablation,decompression,foreign bodies removal,etc.),and according to the proportion of 1∶1∶1,the screened patients were divided into the low dose remimazolam tosilate group(0.1 mg/kg,group A,n=65),medium dose remimazolam tosilate group(0.15 mg/kg,group B,n=70)and high dose remimazolam tosilate group(0.20 mg/kg,group C,n=67).The effective sedation rate,sedation related adverse reactions,postoperative recovery time and the incidence of complications were compared among the three groups.Results There was no statistically significant difference in the effective sedation rate among the low dose group,medium dose group and high dose group(P>0.05).Compared with the low dose group,the higher the initial dose of rimazolam,the shorter the onset time was.The postoperative recovery time in the high dose group was(1.21±0.66)min,which was shorter than that of the low dose group and the medium dose group,and the difference was statistically significant(P=0.034,P=0.014).There was no correlation between the total amount of sedativesand postoperative recovery time(P<0.05).The incidence rate of hypotension in the high dose group was significantly lower than that in the medium dose group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the occurrence rate of bradycardia,tachycardia and hypoxemia among the three groups.Conclusion Application of remimazolam tosilate in painless colonoscopy has quick induction,rapid recovery and little influence on hemodynamics.The recommended
作者
陶勇
李琼
孙婷婷
胡悦
TAO Yong;LI Qiong;SUN Tingting;HU Yue(Department of Anesthesia and Surgery,Shuangliu District First People′s Hospital,Chengdu,Sichuan 610200,China)
出处
《重庆医学》
CAS
2022年第9期1506-1510,1515,共6页
Chongqing medicine
基金
四川省国际医学交流促进会基金资助项目(L20200509015)。
