【摘要】 目的 比较苯磺酸瑞马唑仑、依托咪酯-丙泊酚、丙泊酚在无痛舒适医疗中的镇静作用和安全性。方法 选择2019年1月—2022年1月在本院自愿接受无痛检查、治疗患者360例作为研究对象，男157例，女203例，年龄18-65岁，ASAⅠ或Ⅱ级，随机均分R组、EP组和P组三组，每组各120例。R组作为观察组，应用苯磺酸瑞马唑仑0.15 mg/kg+盐酸纳布啡0.15 mg/kg, EP组应用依托咪酯20 mg配比1%丙泊酚100 mg（容量比1︰1）5-10 ml+盐酸纳布啡0.15 mg/kg、P组应用丙泊酚1.5 mg/kg+盐酸纳布啡0.15 mg/kg。观察三组患者术中的收缩压（SBP）、心率（HR）、血氧饱和度（SpO₂）,术中低血压、心动过缓、呼吸抑制、注射痛及术后头晕、恶心呕吐和苏醒时间。结果 三组药物起效时间、操作时间及苏醒时间比较，差异无统计学意义（P>0.05）;睫毛反射消失时和操作时，R组和EP组对患者HR和SBP的影响较P组影响小，差异有统计学意义（P<0.05）;三组患者术中不良反应发生率比较，R组低于EP组和P组，差异均有统计学意义（P<0.05）;三组患者术后不良反应比较，R组低于EP组和P组，差异均有统计学意义（P<0.05）。结论 苯磺酸瑞马唑仑起效迅速，苏醒恢复快，对循环、呼吸抑制轻微，安全性高，患者诊疗过程中舒适度较好，是无痛舒适医疗的理想药物选择。更多还原

【Abstract】 Objective To compare the sedative effectof remimazolambenzenesulfonate,etomidatepropofol and propofol in painless comfortable medical treatment,and analysis of its safety.Methods Three hundred and sixty adult patients,volunteer to undergoing painless testing and treatment,157 males and 203females,with ASA grade Ior II,aged from 18 to 65 years old,were randomly divided into three groups,with 120cases in each group.Group R was set as observation group,and patients in this group received 0.15mg/kg remimazolam combined with 1.5mg/kg nalbuphine hydrochloride.In group EP,the ratio of etomidate （20mg） and propofol （the concentration was 1%,and the total amount was 100mg） in volume was 1:1,5 to 10 m L of then mixture combined with 1.5mg/kg nalbuphine hydrochloride was adopted in this group.Patients in group P received1.5mg/kg propofolcombined with 1.5mg/kg nalbuphine hydrochloride.Intra-operative systolic blood pressure（SBP）,heart rate （HR）,bloodoxygen saturation （SPO₂）,hypotension,bradycardia,respiratory depression,injection pain,postoperative dizziness,nausea and vomiting and awakening in the two groups were observed.Results There were no significant differences in drug onset time,operation time and awakening time among the3 groups （P>0.05）.R group and EP group had less influence on HR and SBP than P group at the time points eyelash reflexes and operating,and the difference was statistically significant （P<0.05）.The incidence of intraoperative adverse reactions in R group was lower than those of the group EP and group P,and all the difference were statistically significant （P<0.05）.Comparison of postoperative adverse reactions among the 3 groups:the incidence of postoperative adverse reactions in group R was lower than that in group EP and group P,and the difference was statistically significant （P<0.05）.Conclusions Remimazolam benzenesulfonatehas the advantages of rapid effect,quick recovery,mild cardiovascular and respiratory inhibition and higher safety.The comfort of patients in the process of diagnosis and treatment is good,so it is an ideal choice of painless and comfortable medicine.更多还原