苯磺酸瑞马唑仑复合小剂量舒芬太尼用于纤维支气管镜检查的效果

Effect of remimazolam besylate combined with low-dose sufentanil in fiberoptic bronchoscopy

摘要:

目的 探讨苯磺酸瑞马唑仑复合小剂量舒芬太尼用于纤维支气管镜检查的临床疗效。方法 选取2024年9月－2025年2月于该院在镇静麻醉下接受纤维支气管镜检查的患者96例，随机分组为P组（接受丙泊酚中/长链脂肪乳注射液干预）和R组（接受苯磺酸瑞马唑仑干预）。所有患者均按0.1 μg/kg的剂量静脉注射舒芬太尼注射液，1 min后，P组予以丙泊酚中/长链脂肪乳注射液2.00 mg/kg，R组予以苯磺酸瑞马唑仑0.20 mg/kg进行麻醉诱导，术中，视麻醉效果，追加相应镇静药物。观察两组患者给药前（T₀）、纤维支气管镜通过声门时（T₁）、纤维支气管镜抵达气管隆嵴时（T₂）、检查结束时（T₃）和离开麻醉恢复室（PACU）时（T₄）的经皮动脉血氧饱和度（SpO₂）、心率（HR）和平均动脉压（MAP）。比较两组患者的呛咳评分、麻醉诱导时间、内镜检查时间、麻醉复苏时间和恢复定向力时间，以及术中追加镇静药物的例数。记录两组患者术中呼吸抑制发生率、气道干预率、诱导时注射痛发生率和低血压发生率。结果 所有患者均完成纤维支气管镜检查。两组患者T₁和T₂时点的MAP明显低于T₀时点；R组T₁和T₂时点的MAP明显高于P组，差异均有统计学意义（P < 0.05）。两组患者呛咳评分、麻醉诱导时间、内镜检查时间、恢复定向力时间和追加镇静药物例数比较，差异均无统计学意义（P > 0.05）；R组麻醉复苏时间明显长于P组，呼吸抑制、气道干预、低血压和注射痛的发生率明显低于P组，差异均有统计学意义（P < 0.05）。结论 苯磺酸瑞马唑仑复合小剂量舒芬太尼用于纤维支气管镜检查，麻醉效果稳定。苯磺酸瑞马唑仑相较于丙泊酚，具有更稳定的血流动力学，且呼吸系统相关不良反应和注射痛发生率较低，用于纤维支气管镜的诊断和治疗是安全且有效的。

Abstract:

Objective To explore the efficacy of the anesthesia regimen combining remimazolam besylate and low-dose sufentanil in fiberoptic bronchoscopy.Methods 96 patients who underwent fiberoptic bronchoscopy under sedation and anesthesia from September 2024 to February 2025 were selected and randomly divided into group P (received propofol medium/long chain fatty emulsion injection) and group R (received remimazolam besylate). All patients were intravenously injected with sufentanil injection at a dose of 0.1 μg/kg. One minute later, group P was given 2.00 mg/kg of propofol medium/long chain fat emulsion injection, and group R was given 0.20 mg/kg of remimazolam besylate for anesthesia induction. The percutaneous arterial oxygen saturation (SpO₂), heart rate (HR), and mean arterial pressure (MAP) of the two groups of patients were observed before administration (T₀), when fiberoptic bronchoscopy passed through the glottis (T₁), when fiberoptic bronchoscopy reached the carina of the trachea (T₂), at the end of the examination (T₃), and when leaving the postanesthesia care unit (PACU) (T₄). The choking cough score, anesthesia induction time, endoscopic examination time, anesthesia recovery time, time to regain orientation, and the number of additional sedative drugs during the operation of the two groups of patients were compared. Record the occurrence of intraoperative respiratory depression events, the number of airway intervention cases, the incidence of injection pain during induction, and the incidence of hypotension in the two groups of patients.Results All patients underwent fiberoptic bronchoscopy. At the T₁ and T₂ time points, the MAP of both groups was lower than that at the T₀ time points, the MAP of the group R was higher than that of the group P at the T₁ and T₂ time points, the differences were statistically significant (P < 0.05). There were no statistically significant differences in the choking cough score, induction time, endoscopic examination time, and time to regain orientation, and the number of additional sedative drugs between the two groups (P > 0.05); The awakening time of the group R was significantly longer than that of the group P, the incidences of respiratory depression, airway intervention, hypotension, and injection pain in the group R were all lower than those in the group P, the differences were statistically significant (P < 0.05).Conclusion The anesthetic effect of remimazolam besylate combined with low-dose sufentanil in fiberoptic bronchoscopy is stable. Remimazolam besylate has more stable hemodynamics compared with propofol, and has a lower incidence of respiratory system-related adverse reactions and injection pain. It is safe and effective for the diagnosis and treatment of fiberoptic bronchoscopy.