Abstract:

Objective　To investigate the effect of remazolam on cognitive function and hemodynamics in elderly patients undergoing painless gastroenteroscopy. Methods　One hundred and two elderly patients undergoing painless gastroenteroscopy at Shouguang Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were selected for the randomized controlled trial, and were divided into an observation group and a routine group by the random number table method, with 51 cases in each group. There were 31 males and 20 females in the observation group; they were (9.63±6.25) years old. There were 20 males and 31 females in the routine group; they were (79.06±6.93) years old. The observation group took tsyloremazolam and afentanil for anesthesia, and the routine group took propofol and afentanil for anesthesia. The times to come to and times to leave the room, the scores of Mini-Mental State Examination before and 2 and 5 d after the operation, and the blood pressures and oxygen saturations before (T₁) and 3 (T₂), 6 (T₃), and 9 min (T₄) after administration were compared between the two groups. t and χ² tests were applied. Results　The time to come to and the time to leave the room in the observation group were shorter than those in the routine group [(7.25±1.15) min vs. (9.69±1.68) min and (28.74±4.25) min vs. (37.85±6.23) min], with statistical differences (t=14.195 and 7.852; both P<0.05). There were statistical differences in the scores of MMSE of group, time, and interaction between the two groups (F_{between groups}=17.358; F_time=19.652; F_interaction=13.745; all P<0.05). The scores of MMSE 2 and 5 d after the operation in the observation group were higher than those in the routine group. The systolic and diastolic blood pressures and oxygen saturation at T₂ in the observation group were higher than those in the routine group (F_{between groups}=9.580, 9.541, and 19.520; all P<0.05). The systolic and diastolic blood pressures and oxygen saturation at T₃ and T₄ were higher than those at T₂ in the routine group (F_时间=8.852, 9.580, and 8.520; all P<0.05). Conclusion　Applying remazolam in painless gastroenteroscopy in elderly patients can shorten their time to come to, improve their cognitive function, and reduce the impact on their hemodynamics, which is worthy of clinical application.

Key words:

Remazolam, Alfentanil, Painless gastroenteroscopy examination, Cognitive function, Hemodynamics, Elderly patients

摘要：

目的　探讨瑞马唑仑联合阿芬太尼在老年患者无痛胃肠镜检查中的应用及对患者认知功能和血流动力学的影响。方法　选取2021年1月至2022年12月寿光市中医医院收治的102例行无痛胃肠镜检查的老年患者进行随机对照试验，依照随机数字表法分为观察组和常规组，各51例。观察组男31例、女20例，年龄（9.63±6.25）岁，采用甲苯磺瑞马唑仑+阿芬太尼麻醉；常规组男20例、女31例，年龄（79.06±6.93）岁，采用丙泊酚+阿芬太尼麻醉。比较两组患者苏醒时间、离室时间，分别于术前、术后2 d、术后5 d采用简易精神状态量表（MMSE）评定认知功能，不同时间点［给药前（T₁），给药后3 min（T₂），给药后6 min（T₃），给药后9 min（T₄）］血压、血氧饱和度。统计学方法采用t检验、χ²检验。结果　观察组苏醒时间、离室时间均短于常规组［（7.25±1.15）min比（9.69±1.68）min、（28.74±4.25）min比（37.85±6.23）min］，差异均有统计学意义（t=14.195、7.852，均P<0.05）。两组MMSE评分组间、时间、交互比较，差异均有统计学意义（F_组间=17.358，F_时间=19.652，F_交互=13.745，均P<0.05），且观察组术后2 d、术后5 d的MMSE评分均高于常规组。观察组T₂时刻收缩压、舒张压、血氧饱和度均高于常规组（F_组间=9.580、9.541、19.520，均P<0.05），常规组患者T₃时刻、T₄时刻收缩压、舒张压、血氧饱和度均高于T₂时刻（F_时间=8.852、9.580、8.520，均P<0.05）。结论　瑞马唑仑联合阿芬太尼用于老年患者无痛胃肠镜检查中可以缩短患者苏醒时间，改善患者认知功能，减轻对患者血液动力学的影响，值得在临床中推广应用。

关键词:

瑞马唑仑, 阿芬太尼, 无痛胃肠镜检查, 认知功能, 血液动力学, 老年患者