摘要
Abstract
Objective To explore the safety and efficacy of remimazolam combined with etomidate for elderly patients undergoing painless bronchoscopy.Methods A total of 80 elderly patients,aged≥70 years,of American Society of Anesthesiologists(ASA)physical status Ⅱ or Ⅲ,with body mass index(BMI)16.0-30.0 kg/m2,who underwent painless bronchoscopy at Shaanxi Second Provincial People's Hospital from March 2021 to June 2024 were selected and randomly divided into the control group(n=40)and the observation group(n=40)using a random number table method.Both groups received plasma target-controlled infusion of remifentanil at 5 ng/mL.After 3 min,the control group was given propofol+etomidate+mivacurium chloride,and the observation group was given remimazolam+etomidate+mivacurium chloride,and assisted ventilation was performed for 5 min after the disappearance of spontaneous breathing.A laryngeal mask was inserted,and the remifentanil effect chamber reached 5 ng/mL.The mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2),and bispectral index(BIS)before anesthesia induction(T0),immediately after anesthesia induction(T1),when entering the glottic region(T2),5 min after initiation of bronchossopy(T3),when the endoscopy was removed out of the glottic region(T4),the moment of removing the laryngeal mask(T5),and before leaving the bronchoscope exam room(T6)were recorded.The time from drug withdrawal to respiratory recovery of the patients,the time of extubation,and the time to reach the criteria for leaving the room were recorded.The number of cases of adverse reactions such as injection pain,hypotension,and bradycardia were recorded.The addition of sedative drugs and the use of atropine,norepinephrine and epinephrine were recorded.Results At T1,T2,T3,T4 MAP and HR of the observation group were higher than those of the control group(P＜0.05),while there was no statistically significant difference in SpO₂ and BIS between the two groups(P＞0.05);there was no statistically significant difference in the respiratory recovery time and extubation time between the two groups(P＞0.05);there was no statistically significant difference in the dosage and frequency of the additional sedative drug etomidate between the two groups(P＞0.05);the dosage of atropine,norepinephrine and epinephrine used in the observation group was lower than that in the control group,with statistically significant difference(P＜0.01).Conclusion Remimazolam combined with etomidate for elderly patients undergoing painless bronchoscopy has relatively stable hemodynamics,few adverse reactions,high safety,and can be promoted.关键词
瑞马唑仑/瑞芬太尼/老年患者/血流动力学/无痛支气管镜/安全性/有效性Key words
remimazolam/remifentanil/elderly patients/hemodynamics/painless bronchoscope/safety/efficacy
