中国临床药理学杂志

甲苯磺酸瑞马唑仑与丙泊酚在老年人无痛内镜逆行胰胆管造影术的临床研究

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徐湘湘 ¹^,² , 郭凤强 ² , 杨彦玲 ¹

中国临床药理学杂志 | 临床与基础桥接研究 2025,41(18): 2618-2623

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中国临床药理学杂志 |临床与基础桥接研究 2025 , 41 (18) : 2618 -2623

甲苯磺酸瑞马唑仑与丙泊酚在老年人无痛内镜逆行胰胆管造影术的临床研究

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徐湘湘¹^,², 郭凤强², 杨彦玲¹

作者信息

^1.延安大学医学院生理教研室，陕西延安 716000

^2.延安市中医医院麻醉手术科，陕西延安 716000

通讯作者:

杨彦玲，教授，硕士研究生导师 MP: 13891184889 E-mail: yangyanling8889@ 163.com

作者简介:

徐湘湘（1993-），女，主治医师，主要从事神经生物学研究及临床麻醉工作和研究

Clinical trial of remifentanil tosylate and propofol in painless endoscopic retrograde cholangiopancreatography in elderly patients

Xiang-xiang XU¹^,², Feng-qiang GUO², Yan-ling YANG¹

Affiliations

^1.Physiology Teaching and Research Section, Yan’an University, School of Medicine, Yan’an 716000, Shaanxi Province, China

^2.Department of Anesthesiology and Surgery, Yan’an Traditional Chinese Medicine Hospital, Yan’an 716000, Shaanxi Province, China

出版时间: 2025-09-28 doi: 10.13699/j.cnki.1001-6821.2025.18.008

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摘要

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目的

观察甲苯磺酸瑞马唑仑注射液与丙泊酚注射液在老年人无痛内镜逆行胰胆管造影术（ERCP）的临床疗效和安全性。

方法

本研究共筛选106例无痛ERCP术治疗的老年患者，根据纳入标准排除4例，最终纳入102例，根据患者的用药情况分为瑞马唑仑组和丙泊酚组，各51例。2组患者均进行全身静脉麻醉，瑞马唑仑组以甲苯磺酸瑞马唑仑复合舒芬太尼麻醉，丙泊酚组以丙泊酚复合舒芬太尼麻醉。对比2组患者的麻醉诱导时间、诱导成功率、术中血流动力学、麻醉苏醒时间、镇痛镇静效果和应激反应指标，并进行安全性评价。

结果

瑞马唑仑组麻醉诱导时间为（5.12±1.23）min显著长于丙泊酚组的（3.39±0.92）min，首次诱导成功率52.94%显著低于丙泊酚组的80.00%（均P<0.05）。瑞马唑仑组和丙泊酚组睁眼时间分别为（4.96±1.58）和（8.00±2.03）min；意识恢复时间分别为（5.92±1.64）和（9.10±2.59）min；气管拔管时间分别为（10.08±2.87）和（13.06±3.12）min；恢复室停留时间分别为（21.22±5.18）和（26.35±5.83）min，瑞马唑仑组睁眼、意识恢复、气管拔管和恢复室停留时间均显著小于丙泊酚组（均P<0.05）。检查结束后，瑞马唑仑组和丙泊酚组VAS评分分别为（2.61 ±0.69）和（3.14±0.81）分，瑞马唑仑组VAS评分显著低于丙泊酚组（P<0.05）。术后24 h，瑞马唑仑组和丙泊酚组的的肾上腺素（E）分别为（42.11±5.93）和（47.12±6.01）ng·mL^-1；去甲肾上腺素（NE）分别为（67.28±7.84）和（72.46±8.10）ng·mL^-1；皮质醇（COR）分别为（105.43±11.25）和（111.23±12.34）ng·mL^-1；瑞马唑仑组E、NE和COR均显著低于丙泊酚组（均P<0.05）。瑞马唑仑组和丙泊酚组的药物不良反应发生率分别为9.80%和27.45%，瑞马唑仑组药物不良反应发生率显著低于丙泊酚组（P<0.05）。

结论

瑞马唑仑注射液用于老年人无痛ERCP诊疗术诱导时间长于丙泊酚，但诱导后及术中循环更加平稳，应激性反应更低，苏醒迅速且未出现严重药物不良反应，可临床推广应用。

关键词

丙泊酚注射液 / 甲苯磺酸瑞马唑仑注射液 / 内镜逆行胰胆管造影术 / 老年患者 / 苏醒时间 / 血流动力学

Abstract

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Objective

To compare and analyze the application effects of remifentanil tosylate injection and propofol injection in painless endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients.

Methods

A total of 106 elderly patients who underwent painless ERCP for treatment were included in this study. After excluding 4 patients according to the inclusion criteria, 102 patients were finally included. They were divided into two groups based on the medication used: the remimazolam group and the propofol group, with 51 patients in each group. Both groups of patients received general intravenous anesthesia. The remimazolam group was anesthetized with remimazolam mesylate combined with sufentanil, while the propofol group was anesthetized with propofol combined with sufentanil. Compared the anesthesia induction time, induction success rate, intraoperative hemodynamics, anesthesia recovery time, hemodynamics, stress response indicators between two groups of patients, and the safty was comparied.

Results

The anesthesia induction time of the remimazolam group was (5.12±1.23) min, which was significantly longer than that of the propofol group (3.39±0.92) min. The success rate of the first induction was 52.94%, which was significantly lower than that of the propofol group 80.00% (all P<0.05). The eye-opening time of the remimazolam group and the propofol group were (4.96±1.58) and (8.00±2.03)min, respectively; the time for consciousness recovery were (5.92±1.64) and (9.10±2.59)min, respectively; the tracheal extubation time were (10.08±2.87) and (13.06±3.12) minutes, respectively; the retention time in the recovery room were (21.22±5.18) and (26.35±5.83) min, respectively. The eye opening, consciousness recovery, tracheal extubation and retention time in the recovery room in the remimazolam group were all significantly shorter than those in the propofol group (all P<0.05). After the examination, the VAS scores of the remimazolam group and the propofol group were (2.61±0.69) and (3.14±0.81) points, respectively; the VAS score of the remimazolam group was lower than that of the propofol group (P<0.05). At 24 h after the operation, the levels of epinephrine (E) in the remimazolam group and the propofol group were (42.11±5.93) and (47.12±6.01) ng·mL^-1, respectively; the levels of norepinephrine (NE) were (67.28±7.84) and (72.46±8.10) ng·mL^-1, respectively; the cortisol (COR) levels were (105.43±11.25) and (111.23±12.34) ng·mL^-1, respectively. The E, NE and COR in the remimazolam group were all significantly lower than those in the propofol group (all P<0.05). The incidence of adverse drug reactions in the remimazolam group and the propofol group were 9.80% and 27.45%, respectively. The incidence of adverse drug reactions in the remimazolam group was lower than that in the propofol group (P<0.05).

Conclusion

Compared with propofol injection, the induction time of remifentanil tosylate injection for painless ERCP diagnosis and treatment in elderly patients is significantly longer than propofol injection, but the circulation after induction and during surgery is smoother, the stress response is lower, the recovery is rapid, and there are no serious adverse reactions. It can be clinically promoted and applied.

Key words

propofol injection / rimazolen tosylate injection / endoscopic retrograde cholangiopancreatography / elderly patients / wake-up time / hemodynamics

引用本文

徐湘湘, 郭凤强, 杨彦玲. 甲苯磺酸瑞马唑仑与丙泊酚在老年人无痛内镜逆行胰胆管造影术的临床研究. 中国临床药理学杂志, 2025 , 41 (18) : 2618 -2623 . DOI: 10.13699/j.cnki.1001-6821.2025.18.008

Xiang-xiang XU, Feng-qiang GUO, Yan-ling YANG. Clinical trial of remifentanil tosylate and propofol in painless endoscopic retrograde cholangiopancreatography in elderly patients[J]. Chinese Journal of Clinical Pharmacology, 2025 , 41 (18) : 2618 -2623 . DOI: 10.13699/j.cnki.1001-6821.2025.18.008

基金

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陕西省中医药管理局委托任务基金资助项目(SZY-NLTL-2022-020)

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2025年第41卷第18期

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文章信息

doi: 10.13699/j.cnki.1001-6821.2025.18.008

接收时间：2025-04-25
首发时间：2026-08-05
出版时间：2025-09-28

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收稿日期：2025-04-25

基金

陕西省中医药管理局委托任务基金资助项目(SZY-NLTL-2022-020)

作者信息

^1.延安大学医学院生理教研室，陕西延安 716000

^2.延安市中医医院麻醉手术科，陕西延安 716000

通讯作者:

杨彦玲，教授，硕士研究生导师 MP: 13891184889 E-mail: yangyanling8889@ 163.com

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https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2025.18.008

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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