Effect of Remimazolam Tosilate Combined with Esketamine on Painless Enteroscopy Mucosal Dissection

YU Jianmin; SONG Linlin; GAO Na

doi:10.14033/j.cnki.cfmr.2023.36.003

Abstract：Objective:To investigate the effect of Remimazolam Tosilate combined with Esketamine on painless enteroscopy mucosal dissection.Method:A total of 60 patients who underwent painless enteroscopy mucosal dissection in Binzhou People's Hospital from October 2021 to June 2023 were selected and divided into group A,group B and group C by random number table method,with 20 patients in each group.All three groups were given intravenously Remimazolam Tosilate,group A was given intravenous Esketamine,group B was given Remifentanil,and group C was given the same amount of 0.9％Sodium Chloride Solution.The preparation time,recovery time and time of full waking were compared among the three groups.Hemodynamic indexes(heart rate,mean arterial pressure)at 5 min before anesthesia(T0),at the time of endoscopy(T1),at the time of tumor margin labeling(T2),at the time of submucosal resection(T3),at the end of surgery(T4)of the three groups were compared,and visual analogue scale(VAS)scores at 1 h after surgery(T5),3 h after surgery(T6)and 6 h after surgery(T7)were compared between the three groups.The occurrence of adverse reactions during hospitalization was compared among the three groups.Result:There was no significant difference in preparation time among the three groups(P>0.05).The full waking time and recovery time of group A were shorter than those of group B and group C,and the recovery time and full waking time of group B were shorter than those of group C,the differences were statistically significant(P<0.05).At T1,T2 and T3,the heart rate and mean arterial pressure of the three groups were all higher than those at T0,at T2 and T3,the heart rate and mean arterial pressure of the three groups were all higher than those at T1;at T3,the heart rate and mean arterial pressure of the three groups were higher than those at T2;at T4,the heart rate and mean arterial pressure of the three groups were lower than those at T1,T2 and T3,and the differences were statistically significant(P<0.05).At T1,T2,T3 and T4,the heart rate and mean arterial pressure of group A were lower than those of group B and group C,and the heart rate and mean arterial pressure of group B were lower than those of group C,the differences were statistically significant(P<0.05).At T6 and T7,the VAS score of the three groups were lower than those of T5,and at T7,the VAS score of the three groups were lower than those of T6,the differences were statistically significant(P<0.05).At T5,there was no significant difference in VAS scores among the three groups(P>0.05).At T6 and T7,VAS scores of group A were lower than those of group B and group C,and VAS scores of group B were lower than those of group C,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions among the three groups(P>0.05).Conclusion:Patients undergoing painless enteroscopy mucosal Dissection surgery treated with Remimazolam Tosilate combined with Esketamine can promote recovery,reduce pain,and be safe,reliable,and stable in hemodynamics.