Clinical Application Of Remimazolam Tosilate In Elderly Patients With Endoscopic Ultrasonography

Objective:To investigate the effect of remazolam toluene sulfonate on hemodynamics and safety in elderly patients with ultrasound gastroscopyMethods:A total of 84 elderly patients who underwent ultrasound gastroscopy in our hospital from June to October 2021 were selected and randomly divided into 2 groups by random number table method: control group(group C)and experimental group(group R),with 42 cases in each group.All patients routinely fasted for 8 h and forbade clear drink for 2 h.After entering the endoscopic examination room,the venous access of the right upper limb was opened.Heart Rate(HR),Blood Pressure(BP),Respiratory Rate(RR),Pulse Oxygen Saturation,were routinely monitored.Sp O2),Bi pectral Index(BIS).Nasal catheterization with oxygen flow rate of 3~4 L.min-1.Sufentanil citrate injection 0.1 μg.kg-1 was injected intravenously slowly 3 minutes before ultrasound gastroscopy.Group R was intravenously injected with Ramazolam toluenesulfate 0.1 mg.kg-1,with ramazolam 0.4-1.2mg.kg-1.h-1;Group C was intravenously injected with propofol medium long chain fat milk injection 1.5mg.Maintain BIS 40-60 and adjust Remazolam and propofol pumping rates according to BIS values.BIS < 60 is considered to meet the target sedation depth,and the operation begins.After the operation,group R was given flumazenil 0.5mg intravenously.The Heart Rate(HR)and Blood Pressure(Blood Pressure)of the two groups were recorded at the time of entry(T0),after the end of sedative administration(T1),at the time of admission(T2),5min after the admission(T3),at the time of exit(T4)and 30 min after the exit(T5).BP),Respiratory Rate(RR),Pulse Oxygen Saturation(Sp O2),Bispectral Index,BIS),Modified Observer’s Assessment of Alert/Sedation(MOAA/S);The time of operation,the time from emergence to recovery,and the recovery time of directional force of the two groups were recorded.The incidence of intraoperative injection pain,hypotension,bradycardia and respiratory depression were recorded in the two groups.Postoperative nausea and vomiting,postoperative agitation,dizziness,the incidence of intraoperative awareness and satisfaction were recorded in the two groups.Results:(1)There was no significant difference in preoperative general data(ASA grade,age,gender,body mass index)between 2 groups(P>0.05);There was no significant difference in some intraoperative data(operation time)between the two groups(P>0.05).There was no significant difference in some postoperative data(nausea and vomiting,postoperative agitation and intraoperative known incidence)between the two groups(P>0.05).(2)BP,HR,RR,Sp O2 and BIS in group R were higher than those in group C at T1,T2,T3 and T4(P < 0.05).(3)Compared with group C,the recovery time of awakening and directional force in group R was decreased(P < 0.05);(4)Compared with group C,the incidence of intraoperative injection pain,hypotension,respiratory depression and bradycardia in group R were all decreased(P < 0.05).(5)Compared with group C,the incidence of postoperative dizziness in group R was decreased(P < 0.05),and the satisfaction was increased(P < 0.05).Conclusions:The application of remazolam in the ultrasonic gastroscopy of elderly patients is conducive to stable hemodynamics,high safety,fast recovery,less adverse reactions,and high patient satisfaction.