[罂粟摘要]肝硬化患者在进行胃镜检查的中联合使用瑞马唑仑与舒芬太尼：一项随机对照研究

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肝硬化患者在进行胃镜检查的中联合使用瑞马唑仑与舒芬太尼：一项随机对照研究

贵州医科大学  麻醉与心脏电生理课题

翻译:  严旭

编辑:  严旭

审校: 曹莹

背景：这项前瞻性、随机、对照研究评估了瑞马唑仑与丙泊酚相比,对接受胃镜检查的肝硬化患者的疗效和安全性。

材料和方法：接受胃镜检查的肝硬化患者(年龄为18-65岁)（n=148）并随机分为0.107mg/kg瑞马唑仑（瑞马唑仑组）或2mg/kg丙泊酚(丙泊酚组)。患者在服用药物之前静脉注射了0.15ug/kg的舒芬太尼。必要时重复使用额外剂量的丙泊酚20mg。主要结果为内镜医生对镇静剂的满意度（满意、一般或不满意）。次要结果为并发症（呼吸抑制、呼吸暂停、身体运动、心动过缓、低血压、恶心或呕吐、嗜睡、头晕和发烧）和患者满意度。

结果：与丙泊酚组相比，瑞马唑仑组的镇静时间更长，并发症出现的时间更短。内镜医生评分令人满意的瑞马唑仑组百分比（90.5%）高于丙泊酚组（77.0%；P=0.026）。与丙泊酚组相比，使用瑞马唑仑的患者呼吸抑制、身体运动和低血压的发生比率较低（分别为2.7、8.1、4.1%）（分别为1）（17.6、23.0、14.9%；P=0.003、0.013、0.025）。这2组在其他次要结果方面具有可比性。

结论：对于接受胃镜检查的肝硬化患者，瑞马唑仑与舒芬太尼的联合提供了令人满意的镇静水平，并具有良好的安全性。

原始文献来源：

YingHao Cao , Ping Chi , Chen Zhou ,Remimazolam Tosilate Sedation with Adjuvant Sufentanil in Chinese Patients with Liver Cirrhosis Undergoing Gastroscopy: A Randomized Controlled Study,Med Sci Monit. 2022 Jun 16;28:e936580.doi: 10.12659/MSM.936580.

英文原文：

Remimazolam Tosilate Sedation with Adjuvant Sufentanil in Chinese Patients with Liver Cirrhosis Undergoing Gastroscopy: A Randomized Controlled Study

Abstract

BACKGROUND: This prospective, randomized, controlled study evaluated the efficacy and safety of remimazolam tosilate sedation with adjuvant sufentanil, relative to propofol, for Chinese patients with liver cirrhosis undergoing gastroscopy. 

MATERIAL AND METHODS: Patients with liver cirrhosis (n=148) aged 18-65 years and undergoing gastroscopy were randomly and equally allocated to receive either 0.107 mg/kg remimazolam tosilate (remimazolam group) or 2 mg/kg propofol. Patients received intravenous sufentanil 0.15 μg/kg before the study drug. If necessary, an additional dose of propofol 20 mg was used and repeated. The primary outcome was the satisfaction rating (satisfactory, fair, or unsatisfactory) of the endoscopist with the sedation. Secondary outcomes were complications (respiratory depression, apnea, body movement, bradycardia, hypotension, nausea or vomiting, somnolence, dizziness, and fever) and patient satisfaction. 

RESULTS: Compared with the propofol group, the remimazolam group required a longer time to sedation and a shorter time to emergence. The percentage of remimazolam sedations the endoscopist rated satisfactory (90.5%) was higher than that for propofol (77.0%; P=0.026). Patients given remimazolam experienced lower rates of respiratory depression, body movement, and hypotension (2.7, 8.1, 4.1%, respectively), than did the propofol group (17.6, 23.0, 14.9%; P=0.003, 0.013, 0.025). The 2 groups were comparable regarding the other secondary outcomes. 

CONCLUSIONS: For Chinese patients with liver cirrhosis undergoing gastroscopy, remimazolam tosilate with adjuvant sufentanil provides a satisfactory level of sedation with a good safety profile.

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