Comparison of the application effects of remimazolam and propofol combined with sufentanil in elderly patients undergoing painless gastroscopy and their impacts on recovery quality

XU Hechen; CHEN Yuanyang; WU Hongqi; JIANG Ke; ZOU Xiaohua

doi:10.3969/j.issn.1674-3806.2024.09.09

Abstract：Objective To compare the application effects of remimazolam and propofol combined with sufentanil in elderly patients undergoing painless gastroscopy and their impacts on recovery quality.Methods A total of 134 elderly patients undergoing painless gastroscopy in the Affiliated Hospital of Guizhou Medical University from January 2022 to June 2022 were recruited and divided into control group and observation group by random number table method,with 67 cases in each group.The anesthesia regimen of propofol combined with sufentanil was used in the control group,and the anesthesia regimen of remimazolam combined with sufentanil was used in the observation group.The onset time of anesthesia,time of operating gastroscope,awakening time,Quality of Recovery-15(QoR-15)scale scores on the first day after examination,as well as the heart rate(HR),respiratory rate(RR),pulse oxygen saturation(SpO2)and mean arterial pressure(MAP)at the time of entry into the operating room(T,),at the start time of sufentanil administration(T2),at the start time of remimazolam/propofol administration(T3),at the time when the insertion tube of the gastroscope was being inserted(T4),at the time of 3 minutes after the insertion tube of the gastroscope was inserted(T5),at the time of 5 minutes after the insertion tube of the gastroscope was inserted(T6),and at the time when the insertion tube of the gastroscope was withdrawn(T7)between the two groups.The occurrence of adverse reactions was compared between the two groups.Results On the first day after examination,the total QoR-15 scale scores in the observation group were significantly higher than those in the control group(P＜0.05),and among the five dimensions of the QoR-15 scale,the pain scores,physical comfort scores and physical independence scores in the observation group were higher than those in the control group,and the mood state scores in the observation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).There were no significant differences in psychological support scores between the two groups(P＞0.05).From the time point of T4 to the time point of T7,the MAP levels in the observation group were significantly higher than those in the control group(P＜0.05).From the time point of T4 to the time point of T6,the SpO2 levels in the observation group were significantly higher than those in the control group(P＜0.05).There were no significant differences in HR and RR levels between the two groups at each observation time point(P＞0.05).There was no significant difference in the time of operating gastroscope and the onset time of anesthesia between the two groups(P＞0.05).The observation group woke up faster than the control group,and the difference was statistically significant(P＜0.05).The proportion of the patients using vasoactive drugs and the proportion of the patients with drug addition times more than 1,and the incidence rates of hypotension,respiratory depression,nausea and vomiting,choking cough,dizziness,delirium and injection pain in the observation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion The application of remimazolam combined with sufentanil shows good effects on the elderly patients undergoing painless gastroscopy,with stable hemodynamics and low incidence of adverse reactions during the examination,which helps to improve the patients'recovery quality.