文章摘要
瑞马唑仑和丙泊酚用于老年患者无痛胃肠镜检查安全性比较的Meta分析
Comparison of the safety of remazolam and propofol for painless gastroenteroscopy in elderly patients: a meta-analysis
  
DOI：10.12089/jca.2024.04.011
中文关键词: 瑞马唑仑  老年  胃肠镜  Meta分析
英文关键词: Remimazolam  Aged  Gastrointestinal endoscopy  Meta-analysis
基金项目:
作者单位E-mail
尹杏杏 100094,北京市,联勤保障部队第九八四医院麻醉科  
谌天奇 100094,北京市,联勤保障部队第九八四医院麻醉科  
秦珊 石家庄第二医院麻醉科  
宋海波 100094,北京市,联勤保障部队第九八四医院麻醉科  
李香洁 100094,北京市,联勤保障部队第九八四医院麻醉科  
张永明 100094,北京市,联勤保障部队第九八四医院麻醉科 zhangyongming346@126.com 
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中文摘要:
      
目的：比较瑞马唑仑与丙泊酚用于老年患者无痛胃肠镜检查的安全性。
方法：计算机检索PubMed、Cochrane图书馆、Embase数据库、中国知网、万方数据知识服务平台、中国生物医学文献服务系统（SinoMed）和维普中文期刊全文数据库，检索日期为建库至2022年11月，纳入研究组为瑞马唑仑、对照组为丙泊酚应用于老年患者在无痛胃肠镜中的随机对照试验。从符合纳入及排除标准的文献中提取数据，同时采用Review Manager 5.4统计学软件进行分析。
结果：共纳入15篇随机对照研究，共计1 808例患者。Meta分析结果显示，与丙泊酚组比较，瑞马唑仑组注射痛 （OR=0.02，95%CI 0.01～0.05，P<0.001）、呼吸抑制 （OR=0.38，95%CI 0.23～0.62，P<0.001）、低氧血症 （OR=0.33，95%CI 0.16～0.67，P=0.002）、心动过缓 （OR=0.21，95%CI 0.10～0.45，P<0.001）和低血压发生率（OR=0.22，95%CI 0.16～0.30，P＜0.001）明显降低，苏醒时间（MD=-1.34 s，95%CI -2.35～-0.34 s，P=0.009）和离室时间（MD=-6.67 s，95%CI -10.86～-2.48 s，P=0.002）明显缩短。
结论：与丙泊酚比较，瑞马唑仑用于老年患者无痛胃肠镜检查时血流动力学更稳定，注射痛、呼吸抑制等不良事件的发生率明显降低，苏醒时间和离室时间明显缩短，但在诱导时间和恶心呕吐、眩晕的发生率方面无明显差异。
英文摘要:
      
Objective: To compare the safety of remimazolam and propofol in elderly patients undergoing painless gastroenteroscopy.
Methods: PubMed, Cochrane Library, Embase database, China Knowledge Network, Wanfang Data Knowledge Service Platform, China Biomedical Literature Service System (SinoMed), and VIP Chinese Journal Full Text Database were searched from the creation of the database to November 2022, and elderly patients undergoing painless gastroenteroscopy were included into the experimental group of remazolam and the control group using propofol in a randomized controlled trial. The literature was carefully reviewed to identify data that met the inclusion and exclusion criteria. The extracted data were analyzed using Review Manager 5.4 statistical software.
Results: Fifteen trials with a total of 1 808 patients were included. The Meta analysis showed that the incidence of injection pain (OR = 0.02, 95% CI 0.01 to 0.05, P < 0.001), respiratory depression (OR = 0.38, 95% CI 0.23 to 0.62, P < 0.001), hypoxemia (OR = 0.33, 95% CI 0.16 to 0.67, P = 0.002), bradycardia (OR = 0.21, 95% CI 0. 10 to 0.45, P < 0.001), hypotension (OR = 0.22, 95% CI 0.16 to 0.30, P < 0.001), awaken time (MD = -1.34 seconds, 95% CI -2.35 to -0.34 seconds, P = 0.009), and discharge time (MD = -6.67 seconds, 95% CI -10.86 to -2.48 seconds, P = 0.002) were significantly reduced.
Conclusion: Compared with propofol, remazolam is more haemodynamically stable when using painless gastroenteroscopy in elderly patients, with a significantly lower incidence of adverse events such as injection pain and respiratory depression, and a significantly shorter time to wake up and time out of the room, but there are no significant differences in induction time and incidence of dizziness, nausea and vomiting.
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