瑞马唑仑复合艾司氯胺酮在超声胃镜检查中的应用

Application of Remazolam Combined with Esketamine in Ultrasonic Gastroscopy

摘要: 目的：探讨瑞马唑仑复合艾司氯胺酮对超声胃镜患者血流动力学，术中、术后不良反应及满意度的影响。方法：选择2022年10月~2023年3月日照市人民医院收治的无痛超声胃镜患者60例，采用随机数字表法将患者分为2组，对照组(C组)和试验组(S组)。两组患者均静脉推注艾司氯胺酮0.5 mg/kg，对照组采用给予丙泊酚1 mg/kg静推；试验组给予瑞马唑仑0.4 mg/kg静推。收集两组患者一般资料，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。记录术中不良反应，包括低血压、注射痛、心律失常等。记录患者术后不良反应(恶心、呕吐)及满意度。结果：两组患者一般情况，包括性别、年龄、体质量指数(BMI)、ASA分级、胃镜检查时长、麻醉至操作开始时间差异无统计学意义(P > 0.05)。两组患者在T1时MAP、HR差异无统计学意义(P > 0.05)。在T2时间点，与C组患者MAP、HR比较，S组患者MAP、HR均降低(P < 0.05)。与C组患者比较，S组患者术中低血压、注射痛发生率均降低(P < 0.05)；两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)。两组患者术后满意度差异无统计学意义(P < 0.05)。结论：瑞马唑仑复合艾司氯胺酮可以为无痛超声胃镜患者提供良好的血流动力学保证，同时降低术中并发症的发生，安全性高。

Abstract: Objective: To investigate the effects of remazolam combined with esketamine on hemodynamics, intraoperative and postoperative adverse reactions and satisfaction in patients undergoing ultra-sonic gastroscopy. Methods: 60 patients with painless ultrasound gastroscopy admitted to the Peo-ple’s Hospital of Rizhao from October 2022 to March 2023 were selected. The patients were divided into 2 groups by random number table method, control group (group C) and experimental group (group S). Both groups of patients were given intravenous injection of esketamine 0.5 mg/kg, and the control group was given intravenous injection of propofol 1 mg/kg. The experimental group was given intravenous bolus of 0.4 mg/kg remazolam. The general data of the two groups of patients were collected, including gender, age, height, weight, ASA classification, and duration of gastrosco-py. The changes of mean blood pressure (MAP) and heart rate (HR) were recorded before anesthe-sia induction (T1) and after gastroscopy (T2). The time from the beginning of anesthesia to the be-ginning of operation was recorded. Intraoperative adverse reactions were recorded, including hy-potension, injection pain, and arrhythmia. Postoperative adverse reactions (nausea, vomiting) and satisfaction were recorded. Results: There was no significant difference in general conditions be-tween the two groups, including gender, age, body mass index (BMI), ASA classification, duration of gastroscopy, and time from anesthesia to operation (P > 0.05). There was no significant difference in MAP and HR between the two groups at T1 (P > 0.05). At T2 time point, compared with MAP and HR in group C, MAP and HR in group S decreased (P < 0.05). Compared with group C, the incidence of intraoperative hypotension and injection pain in group S was lower (P < 0.05). There was no signifi-cant difference in postoperative adverse reactions (nausea and vomiting, itching) between the two groups (P < 0.05). There was no significant difference in postoperative satisfaction between the two groups (P < 0.05). Conclusions: Remazolam combined with esketamine can provide good hemody-namic guarantee for patients with painless ultrasonic gastroscopy, and reduce the occurrence of in-traoperative complications with high safety.