Efficacy and safety of remimazolam at different doses in painless colonoscopy for obese patients
Objective To compare the efficacy and safety of remimazolam at different doses with alfentanil in painless colonoscopy for obese patients.Methods A total of 179 patients undergoing elective painless colonoscopy at the Endoscopy Center of the Second Hospital of Jiaxing from April to December 2022 were enrolled in the study.The patients were randomly divided into four groups;during anesthesia induction,30 second after intravenous injection of 10 μg/kg alfentanil hydrochloride,patients in groups P(n=44),R1(n=45),R2(n=46),and R3(n=44)were administered a slow intravenous injection of propofol 1.50 mg/kg,remimazolam 0.15 mg/kg,remimazolam 0.25 mg/kg,and remimazolam 0.35 mg/kg,respectively.The mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),and pulse oxygen saturation(SpI2)were measured at the time of entering the examination room(T0),during insertion of the scope up to the sigmoid colon(T1),splenic flexure(T2),hepatic flexure(T3),cecum(T4),and at the end of the examination(T5).The examination duration,recovery time,discharge time,operator satisfaction,patient satisfaction,sedation success rate,and adverse events(hypotension,bradycardia,hypoxemia,respiratory depression,injection pain,intraoperative movement,dizziness,and nausea/vomiting)were compared among groups.Results Compared with group P,groups R1,R2 and R3 had significantly shorter recovery time and discharge time(all P＜0.05),operator satisfaction was the highest in group R2(P＜0.05),while the sedation success rate was lowerest in group R1(P＜0.05).Compared with group R1,group R2 showed higher sedation success rates and operator satisfaction(both P＜0.05).Group R3 had longer recovery and discharge times but higher operator satisfaction(all P＜0.05).Compared with group R3,group R2 had shorter recovery and discharge times and higher operator satisfaction(all P＜0.05).Compared with group P,the MAP and SpO2 of group R1 significantly increased at T1 to T3,and the HR and RR significantly increased at T1 to T5;in group R2,MAP and SpO2 significantly increased at T1 to T3,while HR and RR significantly increased at T1 to T5(all P＜0.05);in group R3,MAP significantly increased at T1 to T2,HR significantly increased at T2 to T5,RR significantly increased at T1 to T5,and SpO2 significantly increased at T2(all P＜0.05).Compared with group R3,group R2 had significantly higher MAP and HR at T1(both P＜0.05).Compared with group P,the incidence of hypotension,hypoxemia were significantly lower in groups R1,R2 and R3(all P＜0.05).Conclusion When combined with 10 μg/kg of alfentanil,0.25 mg/kg of remimazolam can provide sufficient sedation depth,stable respiratory and circulatory function,high operator satisfaction,and a low incidence of adverse reactions during colonoscopy in obese patients.It is worth promoting its clinical use.
万方数据
维普
