Objective: To observe and compare the effect of remimazolam combined with nalbuphine and midazolam combined with nalbuphine on postoperative recovery in elderly patients undergoing fibrobronchoscopy.
Methods: A total of 112 elderly patients undergoing fibrobronchoscopy, 56 males and 56 females, aged ≥ 65 years, BMI 18.5-28.0 kg/m2, ASA physical status Ⅰ or Ⅱ, were randomly divided into two groups: midazolam group and remimazolam group, 56 patients in each group. The midazolam group received midazolam 0.03 mg/kg combined with nalbuphine 0.1 mg/kg for anesthesia. The remimazolam group received remimazolam 0.1 mg/kg combined with nalbuphine 0.1 mg/kg for anesthesia. HR, MAP, SpO2, and RR were recorded after entering room, before anesthesia induction, 5 minutes after anesthesia induction, and at the end of the operation. The onset time of anesthesia, the time of awakening, the time of operation, the time of discharge, the number of successful cases of sedation, the number of successful cases of endoscopy, and the occurrence of adverse events were recorded. The satisfaction of the patient, anesthesiologist, and endoscopist were also recorded.
Results: Compared with the midazolam group, HR and MAP were significantly increased 5 minutes after induction and the end of operation in the remimazolam group (P < 0.05), the onset time of anesthesia and the time of awakening were significantly shortened (P < 0.05), the incidence of hypotension, respiratory depression and nausea and vomiting were significantly reduced (P < 0.05), and the rate of very satisfaction of the operating physician was significantly increased (P < 0.05). There were no significant differences in the time of separation, the success rate of sedation and the success rate of endoscopy between the two groups.
Conclusion: Compared with midazolam, remimazolam combined with nalbuphine can be safely used for flexible bronchoscopy in elderly patients, reduce recovery time and adverse reactions, which is conducive to rapid postoperative recovery. |
