Volume 4, Issue 1
1.Department of Anesthesiology,the Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital)
2.Emergency Department (Outpatient Chemotherapy Center),the Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital)
Published： 30 June 2024 ，
Full txt
Wang Qiongchuan,Gong Jiangui,Zhao Li,et al.Efficacy and safety of remimazolam compared with propofol in gastroenteroscopic sedation: a randomized controlled trial[J].Biomedical Data Science,2024,04(01):5-15.
Wang Qiongchuan,Gong Jiangui,Zhao Li,et al.Efficacy and safety of remimazolam compared with propofol in gastroenteroscopic sedation: a randomized controlled trial[J].Biomedical Data Science,2024,04(01):5-15. DOI： 10.47297/wspbdsWSP2752-630501.20240401.
Background
2
—Remimazolam (HR7056
RT) is a new type of ultra-short-acting sedative drug. At present
there are few studies on its use in gastroenteroscopy procedural sedation
and it is not clear whether threr is a good correlation between RT and Bispectral Index (BIS). Therefore
the purpose of this study was to investigate the efficacy and safety of RT for procedural sedation during painless gastroenteroscopy.
Methods
2
—A total of 100 patients who underwent gastrointestinal endoscopy in Yunnan Luliang Peifang Hospital from January 1
2022 to June 30
2022 were included. They met the following cr
iteria: age 18~75 years old
gender was not limited
American Society of Anesthesiologists(ASA) I-II class
body mass index (BMI) is 18.0~28.0kg/m
2
. Patients were randomly divided into AR group and AP group. AR group was given RT0.2mg/kg
supplemented with 0.05mg/kg as needed; AP group was given propofol 2mg/kg
supplemented with 0.5mg/kg. Give sedation supplements and evaluate the sedation effect based on the modified observational alertness/sedation assessment (MOAA/S) score
the time of loss of consciousness (LOC)
successful sedation in one dose
the supplementary dose and recovery time of consciousness were recorded. Adverse reactions related to sedative drugs were recorded
including the incidence of injection pain
hemodynamic events
and respiratory depression. Postoperative nausea and vomiting
visual analog scale (VAS) scores at rest
dizziness and headache
and patient and physician satisfaction were also compared between the two groups.
Results
2
—The data of 97 patients were analyzed finally. The effective rate of sedation in both groups was 100%. The LOC time of the AR group was longer than that of the AP group(47±23s vs. 20±10s
P<0.001). The success rate of one-dose sedation in AR group was lower than that in AP group (P<0.05). The supplementary dose of sedation in AR group was more than that in AP group (P<0.05). Compared with the AP group
the incidence of intraoperative hemodynamic events (6% vs 23%
P<0.05) and respiratory depression (14% vs 33%
P<0.05) in the AR group were significantly reduced
and the incidence of injection pain The rate was also significantly lower than that of the AP group (P<0.001). The intraoperative BIS value in the AR group was significantly higher than that in the AP group (P<0.05)
while there was no difference in the MOAA/S score between the two groups (P > 0.05).
Conclusion
2
—Remimazolam is an effective and safe sedative drug
which can be used in painless gastrointestinal endoscopy. Compared with propofol
it has the advantages of less intraoperative adverse reactions and no injection pain
especially RT sedation can achieve the similar sedative effect as propofol
but does not require a deeper depth of anesthesia. It should be noted that the time to induce sedation is slightly longer when RT is used
and the intraoperative supplementary dose is slightly increased.
RemimazolamPropofolGastrointestinal endoscopyDeep sedationEffectivenessSafety
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