Clinical application of the remimazolam benzenesulfonate combined with sufentanil in elderly patients undergoing painless gastroenteroscopy

Objective To investigate the anaesthetic effects and adverse effects of remimazolam benzenesulfonate combined with sufentanil in elderly patients undergoing painless gastroenteroscopy.

Methods Using the randomized numerical table method, 500 elderly patients undergoing painless gastroenteroscopy were randomly divided into the propofol group(group P) and remazolam group(group R) (250 cases each group). After 2 min of anesthesia induction with 0.05 μg/kg of sufentanil, the 1.5 mg/kg of propofol was injected intravenously into the group P, and the 0.2 mg/kg of remazolam was injected intravenously into group R. Endoscopic examination was performed when OAA/S was ≤2. The 5 mg·kg^-1·h^-1 of propofol was injected intravenously in group P, and the 0.5 mg·kg^-1·h^-1 of remazolam was injected intravenously in group R for anaesthesia maintenance, and the administration stopped after the procedure. If coughing or body motion reaction occurred during the examination, the 0.5 mg/kg propofol was added to group P, and the 0.05 mg/kg remazolam was added to group R. The hemodynamic indexes between two groups were compared at entering the room(T₀), 2 min after induction(T₁), 1 min after gastroscopy(T₂), the end of gastroscopy(T3), 1 min after colonoscopy(T₄), at the end of colonoscopy(T₅), patients awaking(T₆) and lefting PACU(T₇). The time of gastroenteroscopy examination, effective time of sedation, successful rate of sedation, recovery time, dosage of anesthetic drugs, respiratory depression and adverse reactions were compared between two groups.

Results The systolic blood pressure at T₁-T₄, diastolic blood pressure at T1, mean arterial pressure at T₁-T₄, heart rate at T₁-T₅, and blood oxygen saturation at T₁-T₆ in the group P were lower than those in group R(P < 0.05 to P < 0.01), and the noninvasive end-expiratory carbon dioxide pressure at T₁-T₇ in the group P were higher than those in group R(P < 0.05 to P < 0.01). There was no statistical significance in the operation time of gastroenteroscopy and successful rate of sedation between two groups(P>0.05). Compared with the group P, the onset time of sedation was significantly prolonged, the recovery time was significantly shortened, and the dosage of anesthetic drugs was significantly decreased in group R(P < 0.01). The incidence of body in the group R was significantly higher than that in group P(P < 0.01), and the incidence rates of respiratory depression and hiccup, hypotension, bradycardia, injection pain, nausea and vomiting in the group R were lower than those in group P(P < 0.05 to P < 0.01).

Conclusions Remazolam combined with sufentanil can be safely and effectively used in elderly patients undergoing painless gastroenteroscopy, and the postoperative recovery is fast and the incidence of adverse reactions such as respiratory depression is low.