Anesthetic effect of remimazolam combined with remifentanil on gastroscopy in obese patients
LI Xiaoning
JIA Xiaohui
XUE Weihong
Abstract：Objective To investigate the efficacy and safety of remimazolam combined with remifentanil for anes-thesia in gastroscopy for obese patients.Methods A total of 184 obese patients who underwent gastroscopy in Luoyang Central Hospital Affiliated to Zhengzhou University from February 2024 to March 2025 were retrospectively selected and divided into an observation group and a control group based on anesthesia administration regimen,with 92 patients in each group.The con-trol group was intravenously anesthetized with propofol(2 mg/kg)plus remifentanil(1 μg/kg),while the observation group was intravenously anesthetized with remimazolam(0.2 mg/kg)combined with remifentanil(1 μg/kg).The anesthetic effects,vital signs,and occurrence of adverse reactions were recorded and compared between the observation group and the control group.Results The recovery time and discharge time of the observation group were shorter than those of the control group((8.67±1.55)min vs(9.49±1.75)min,(12.45±2.33)min vs(14.12±2.29)min)(t=3.364,4.306,both P<0.05).However,there was no statistically significant difference in the onset time of anesthesia(P>0.05).The Ramsay Sedation Scale scores during and at the end of the examination were higher in the observation group than those in the control group((3.23±0.42)points vs(2.45±0.50)points,(2.64±0.42)points vs(2.05±0.50)points)(t=11.457,8.666,both P<0.05).There were no statistically significant differences in the satisfaction of gastroscopy operators,anesthesiologists and patients between the observation group and the control group(all P>0.05).There were no statistically significant differences in heart rate,mean arterial pressure,blood ox-ygen saturation,and respiratory rate between the observation group and the control group at T0 time point(all P>0.05).The heart rates at T1,T2 in the observation group were lower than those in the control group((80.59±6.88)beats/min vs(89.51±7.78)beats/min,(79.41±6.48)beats/min vs(85.31±6.71)beats/min)(t=8.234,6.067,both P<0.05),while there was no statis-tically significant difference at T3,T4(P>0.05).The mean arterial pressure and blood oxygen saturation during T1-T3 period in the observation group were higher than those in the control group((87.88±7.45)mmHg(1 mmHg=0.133 kPa)vs(78.34±8.22)mmHg,(88.41±6.87)mmHg vs(79.94±8.45)mmHg,(89.87±7.64)mmHg vs(85.11±6.73)mmHg,(98.45±0.48)%vs(95.19±1.96)%,(98.55±0.66)%vs(95.92±1.85)%,(99.35±0.52)%vs(97.83±0.53)%)(t=8.248,7.460,4.484,15.496,12.843,19.636,all P<0.05).There were no statistically significant differences in the changes of respiratory rate among the groups at all each time periods(all P>0.05).The total incidence of adverse reactions in the observation group was 10.87%(10/92),lower than that in the control group(22.83%(21/92))(χ2=4.694,P<0.05).Conclusion The combination of remimazolam and remifentanil for gastroscopy in obese patients can achieve ideal anesthetic efficacy through a synergistic mechanism,while maintaining an ap-propriate depth of sedation.It provides a safe and effective anesthetic guarantee for clinical operations and has a slight impact on the patients'circulatory and respiratory systems.The combination demonstrates rapid awakening with low adverse reaction rates while maintaining high safety,making it clinically viable for widespread adoption.
Keywords：obesityanesthesiaremimazolamremifentanilsafety
Publication Date：2025-10-25
Online Publishing Date：2025-11-03(First online date of this platform, not the publication date of the document)
Pages：5( 1288-1292 )