瑞马唑仑联合曲马多在上消化道内镜黏膜下剥离术中的应用研究

Study of remimazolam combined with tramadol in endoscopic submucosal dissection of upper gastrointestinal tract

摘要:

目的 探讨瑞马唑仑联合曲马多在上消化道内镜黏膜下剥离术（ESD）中的临床效果。方法 选取2024年1月—2025年8月在南通市第一人民医院接受上消化道ESD术的100例患者，采用随机数字表法分为观察组（瑞马唑仑联合曲马多）与对照组（瑞马唑仑联合舒芬太尼），每组50例。对比两组术后视觉模拟评分（VAS）、脑电双频指数（BIS）范围维持率、拔管时间、不良反应及总体临床效果。结果 观察组患者术后3、6、12和24 h VAS评分低分率均高于对照组（P <0.05）；观察组患者BIS值在45～60范围内时间占比高于对照组（P <0.05）；观察组患者术后拔管时间短于对照组（P <0.05）；观察组患者不良反应总发生率低于对照组（P <0.05）；观察组患者优良率高于对照组（P <0.05）。结论 瑞马唑仑联合曲马多在上消化道ESD术中可实现更优的镇静镇痛效果，缩短恢复时间，降低不良反应，具有良好的临床应用价值。

Abstract:

Objective To explore the clinical application effect of remimazolam combined with tramadol in endoscopic submucosal dissection (ESD) of upper gastrointestinal tract.Methods 100 patients who underwent ESD from January 2024 to August 2025 were selected and randomly divided into the observation group (remimazolam + tramadol) and the control group (remimazolam + sufentanil) by random number table method, with 50 cases in each group. Postoperative VAS score, BIS value range maintenance rate, extubation time, adverse reactions and overall clinical outcomes were compared between the two groups.Results The rate of low VAS scores in patients of the observation group at 3 h, 6 h, 12 h and 24 h postoperatively was higher than that in the control group (P < 0.05); The proportion of time that bispectral index (BIS) values stayed within the range of 45 - 60 in the observation group was higher than that in the control group (P < 0.05); The postoperative extubation time of patients in the observation group was shorter than that in the control group (P < 0.05); The total incidence of adverse reactions in the observation group was lower than that in the control group (P < 0.05); The excellent and good rate in the observation group was higher than that in the control group (P < 0.05).Conclusion Remimazolam combined with tramadol can achieve better analgesia and sedation, shorten the recovery time, and reduce the adverse reactions in ESD of upper gastrointestinal tract, which has good clinical application value.