To compare the efficacy and safety of Remimazolam versus propofol combined with nalbuphine for painless gastroenteroscopy anesthesia in alcoholics.

A total of 90 alcoholic patients from Dongguan Songshan Lake Central Hospital from January 2022 to March 2023 were randomly assigned into two groups using a random number table. The observation group (n=45) received remimazolam combined with nalbuphine, while the control group (n=45) received propofol combined with nalbuphine. The onset time of anesthesia, awakening time, recovery time, heart rate (HR), respiratory rate (RR), pulse oxygen saturation (SpO₂) and mean arterial pressure (MAP) were recorded. Pain levels were assessed using the Visual Analog Scale (VAS), and sedation levels were assessed using the Ramsay Sedation Scale.

The onset time, awakening time and recovery time of anesthesia were significantly shorter in the observation group compared to the control group (P<0.05). Both groups experienced significant decreases in HR, RR, SpO₂ and MAP after endoscopy compared to pre-procedure levels (P<0.05), with the observation group significantly more stable hemodynamic parameters (P<0.05). The VAS and Ramsay Scores were significantly lower in the observation group at 5 and 30 minutes after anesthesia awakening (P<0.05). The incidence of adverse reactions was significantly lower in the observation group than in the control group (P<0.05).

Compared with propofol combined with nalbuphine, remimazolam combined with nalbuphine offered superior efficacy and safety for painless gastroscopy anesthesia in alcoholic patients.