不同剂量阿芬太尼复合瑞马唑仑在超声胃镜患者检查中的应用

Application of Different Doses of Alfentanil Combined with Remazolam in Patients Undergoing Ultrasonic Gastroscopy

摘要: 目的：探讨不同剂量阿芬太尼复合瑞马唑仑对超声胃镜患者血流动力学、术后不良反应及满意度的影响。方法：选择2023年3月至2023年9月日照市人民医院收治的无痛超声胃镜患者100例，采用随机数字表法将患者分为3组，A1组、A2组、A3组。A1组患者阿芬太尼静脉注射3 μg/kg，A2组患者阿芬太尼静脉注射5 μg/kg，A3组患者阿芬太尼静脉注射7 μg/kg。收集患者一般资料，包括性别、年龄、身高、体重、ASA分级、胃镜检查时长。记录患者麻醉诱导前(T1)、进胃镜后(T2)平均血压(MAP)、心率(HR)变化，记录患者麻醉开始至操作开始时间。记录患者术后不良反应及满意度。结果：三组患者一般情况，包括性别、年龄、体质量指数(BMI)、ASA分级、胃镜检查时长差异无统计学意义(P > 0.05)。三组患者在T1时MAP、HR差异无统计学意义(P > 0.05)。与A1组患者麻醉至操作开始时间比较，A2组、A3组患者麻醉至操作开始时间均降低(P < 0.05)。在T2时间点，与A1组患者MAP、HR比较，A2组、A3组患者MAP、HR均降低(P < 0.05)；与A2组患者MAP、HR比较，A3组患者MAP、HR均降低(P < 0.05)。三组患者术后不良反应(恶心呕吐、瘙痒)差异无统计学意义(P < 0.05)。三组患者术后满意度差异无统计学意义(P < 0.05)。结论：7 μg/kg阿芬太尼复合瑞马唑仑对超声胃镜患者血流动力学影响较小，安全性更高。

Abstract: Objective: To investigate the effects of different doses of alfentanil combined with remazolam on hemodynamics, postoperative adverse reactions and satisfaction of patients undergoing ultrasonic gastroscopy. Methods: A total of 100 patients with painless ultrasonic gastroscopy admitted to Rizhao People’s Hospital from March 2023 to September 2023 were selected. The patients were di-vided into three groups, A1 group, A2 group and A3 group by random number table method. Pa-tients in group A1 were intravenously injected with 3 μg/kg of alfentanil, patients in group A2 were intravenously injected with 5 μg/kg of alfentanil, and patients in group A3 were intravenously in-jected with 7 μg/kg of alfentanil. General data of patients were collected, including gender, age, height, weight, ASA classification, and duration of gastroscopy. The changes of mean blood pressure (MAP) and heart rate (HR) before anesthesia induction (T1) and after gastroscopy (T2) were rec-orded, and the time from the beginning of anesthesia to the beginning of operation was recorded. The postoperative adverse reactions and satisfaction of patients were recorded. Results: There was no significant difference in the general conditions of the three groups of patients, including gender, age, body mass index (BMI), ASA classification, and duration of gastroscopy (P > 0.05). There was no significant difference in MAP and HR among the three groups at T1 (P > 0.05). Compared with the time from anesthesia to the start of operation in group A1, the time from anesthesia to the start of operation in group A2 and group A3 decreased (P < 0.05). At T2 time point, MAP and HR in group A2 and group A3 were lower than those in group A1 (P < 0.05). Compared with MAP and HR in group A2, MAP and HR in group A3 decreased (P < 0.05). There was no significant difference in postoperative adverse reactions (nausea and vomiting, itching) among the three groups (P < 0.05). There was no significant difference in postoperative satisfaction among the three groups (P < 0.05). Conclusion: 7 μg/kg alfentanil combined with remazolam has little effect on hemodynamics in pa-tients with ultrasonic gastroscopy and is much safer.