Effect of remimazolam combined with remifentanil on hemodynamics in elderly patients undergoing painless bronchoscopy / 中国内镜杂志

ABSTRACT

Objective To explore the effect of remimazolam combined with remifentanil on painless bronchoscopy in elderly patients and observe its impact on hemodynamics.Methods Collect 80 elderly patients underwent bronchoscopy examination from October 2021 to October 2022 as research subjects,and divide them into remifentanil group and combination group according to anesthesia methods.Remifentanil group was given remifentanil assisted painless bronchoscopy,and the combined group was given remimazolam assisted painless bronchoscopy based on remifentanil group.The hemodynamics and operation conditions of the two groups at different time points[before anesthesia induction(T1),at the time of transglottis(T2),1 min after transglottis(T3),5 min after transglottis(T4),at the end of the inspection(T5)]were compared,and the changes of intraoperative and postoperative adverse reactions of patients with different anesthesia methods were observed,and satisfaction analysis was conducted.Results Compared with remifentanil group,the heart rate(HR)in the combined group at T2,T3,and T4 was slower,percutaneous arterial oxygen saturation(SpO2)was lower at T3,T4,diastolic blood pressure(DBP)and systolic blood pressure(SBP)were higher in T2,T3,T4,and the differences were statistically significant(P<0.05).The onset time of drugs was shorter,the recovery time of patients was long,the incidence of hypoxemia,hypotension and HR slowdown was lower,the incidence of HR increased was higher,and the postoperative satisfaction was higher,with statistical significance(P<0.05).There was no statistically significant difference in the incidence of postoperative nausea,vomiting,dizziness,headache,and drowsiness between the two groups of patients(P>0.05).Conclusion Remimazolam combined with remifentanil for painless bronchoscopy in elderly patients may have a good application effect,which can maintain hemodynamic stability,rapid onset,long duration of efficacy,reduce the rate of intraoperative adverse reactions,have a good safety,and can improve patient satisfaction.