The Safety And Efficacy Study Of Remimazolam In Patients Undergoing Colonoscopy Endoscopic Submucosal Dissection

Objective:A new drug,remimazolam,is of ideal sedative charactics,but its suitability for sedation for endoscopic submucosal dissection（ESD）remains to bestudied.The aim of this study is to explore the efficacy and safety of remimazolam for intestinal ESD procedures.Methods:80 ASAⅠ-Ⅱpatients who undergoing colonoscopy ESD surgery were randomly divided into two groups.Both groups were given 10μg of sufentanil citrate injection for pre-analgesia before induction.The propofol group（group A）induced with1-2 mg/kg and maintained with 4-5 mg/kg/h;and the remimazolam group（group B）induced with 0.15 mg/kg and maintained with 0.3-0.5 mg/kg/h.The vital signs and BIS values of the two groups of patients were recorded before induction of anesthesia（T1）,immediate induction of anesthesia（T2）,at the beginning of the operation（i.e.endoscopic placement）（T3）,and 30 min after the operation（T4）,respectively,2 ml of radial artery blood was withdrawn for blood gas analysis after induction of anesthesia（T1）and at the end of the operation（T5）and p H,Pa CO₂,and Lac values were recorded.Finally,the adverse reactions,the total amount of sufentanil citrate injection,and the results of Brice questionnaire were recorded for patients.Results and discussion:1.The heart rate,blood pressure and respiratory rate were less affected in the patients in the remimazolam group compared with the propofol group（P<0.05）,and the differences were statistically significant.2.The intraoperative BIS values fluctuated less in the patients in the remimazolam group than in the propofol group（P<0.05）,and the difference was statistically significant,and there was no intraoperative awareness in either group.3.The comparison of p H,Pa CO₂and Lac values in the blood gas results between the two groups were not statistically significant（P>0.05）,nor was the comparison of Sp O₂between the two groups（P>0.05）.4.The sedation success rate was 100%in both groups;the anesthesia awakening time was longer in the remimazolam group than in the propofol group（P<0.05）,and the difference was statistically significant.5.The incidences of injection pain,respiratory depression,hypotension,hypotension requiring treatment and bradycardia in the propofol group were higher than in the remimazolam group（P<0.05）,and the difference was statistically significant.Conclusion:Compared with propofol,remimazolam for intestinal endoscopic submucosal dissection has a smoother sedation state,more stable hemodynamics,less respiratory depression,lower incidence of adverse effects,and greater safety.