瑞马唑仑对老年衰弱患者无痛胃镜检查术的镇静效果

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Abstract Objective To explore the sedative effect of remazolam on frail elderly patients undergoing painless gastroscopy. Methods A total of 360 frail elderly patients aged 65-80 years old and with the ASA classification of Ⅱ or Ⅲ, the BMI of 18 to 30 kg/m², and CFS score ≥ 5 were selected to undergo elective painless gastroscopy in the outpatient endoscopy center of the Second Hospital of Shanxi Medical University from May to July 2023. Serum Norepinephrine(NA), cortisol (Cor), and Apelin-13 were measured by blood samples during preoperative opening of venous access (T₀) and intraoperative gastroscopy through throat (T₁), respectively. The patients were divided into four groups (n=90) using a randomized numerical table: 0.1, 0.2, 0.3 mg/kg of remazolam in groups R1, R2, and R3, respectively, and 1.5 mg/kg of propofol in group P. Surgery was initiated when the patients' MOAA/S scores were ≤3 and the eyelash reflex disappeared. The success rate of the first sedation, the time of gastroscopy, the time of awakening after the examination and the duration of stay in PACU and the changes of peripheral blood indexes and the incidence of adverse reactions were recorded, and the satisfaction of endoscopists and patients were followed up. Results Compared with P group, the success rate of first sedation (63.3% vs. 96.7%) was significantly lower and the examination time [(7.23±1.81) min vs. (5.78±1.83) min] was significantly longer in R1 group. In addition, NA [(4.72±0.56)ng/ml vs. (3.98±0.52) ng/ml] and Cor [(143.75±10.47) nmol/L vs. (126.61±9.54) nmol/L] in peripheral blood at T₁ were significantly elevated, and the incidence of choking and somatic movement (40.0% vs. 17.7%, 31.1% vs. 13.3%) were significantly higher (P<0.05); whereas, the peripheral blood of Apelin-13 [(2.16±0.49) ng/ml vs. (2.81±0.58) ng/ml] was significantly lower. Intraoperative examination of patients in R2 group was smooth, the incidence of hypotension and low oxygen saturation was significantly lower (P<0.05); In group R3, the awakening time [(12.82±2.33)min] and PACU stay time [(32.5±5.5)min] were significantly longer (P<0.05). Compared with group R1, group R2 had a significantly higher rate of successful first sedation (94.4%), a significantly shorter awakening time [(6.59±2.02) min] and PACU stay [(23.8±5.1) min], and a significantly lower incidence of choking and movement (14.4%, 8.9%) (P<0.05).Compared with R2 group, the awakening time and PACU stay in the R3 group was statistically prolonged (P<0.05). Conclusions Remazolam has good sedative effect and excellent recovery quality, and can be safely and effectively used in gastroscopy in elderly frail patients. The remazolam dose of 0.2 mg/kg can make the examination process of elderly frail patients smoother and reduce the adverse reactions.

Key words： remazolam propofol frail painless gastroscopy

Received: 28 July 2023

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	QIN Wenyan
	FAN Junbai
	YIN Hao
	GAO Tongtong

Cite this article:

QIN Wenyan,FAN Junbai,YIN Hao等. Sedative effect of remazolam on frail elderly patients undergoing painless gastroscopy[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2023, 34(12): 1025-1029.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2023/V34/I12/1025

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