Effect Of Remimazolam On Diaphragmatic Movement In Elderly Patients Undergoing Painless Colonoscopy

Objective:To observe the effect of remimazolam on the movement of diaphragm in elderly patients undergoing painless colonoscopy.Methods:Eighty elderly patients who underwent painless colonoscopy were selected and randomly divided into R group and P group.Group R was sedated with remimazolam 0.2 mg/kg,and group P was sedated with propofol 1.5-2 mg/kg.If the depth of sedation could not meet the requirements,remimazolam was added with 0.05-0.1 mg/kg/time.Or 0.5-1 mg/kg/time of additional propofol until a satisfactory depth of sedation is achieved.The mean arterial pressure(MAP),Heart rate(HR),Pulse oxygen saturation(SpO2),Respiratory rate(RR),Diaphragmatic excursion(DE),Diaphragmatic thickening fraction,DTF),diaphragm thickness(Diaphragm thickness,DE)was recorded before entering the examination room for anesthesia(T0),after the injection of sedative drugs when Ramsay score≥5 points(T1)and after colonoscopy when Ramsay score<2 points(T2).And recorded adverse events such as respiratory depression and diaphragm depression.Results:1.There was no significant difference in age,gender,height,weight,body mass index(BMI),ASA classification,and time of colonoscopy between the two groups(P<0.05).2.Comparison of hemodynamics,respiratory rate and SPO2 between the two groups:MAP in the two groups at T1 and T2 was lower than that at T0(P<0.05),while that in the R group was higher than that in the P group(P<0.05);HR at T1 and T2 were higher than those in groupP(P<0.05);SpO2 in both groups decreased significantly at T1,and group R was significantly higher than group P(P<0.05);respiratory rates in both groups decreased significantly at T1,but the R group was higher than the P group(P<0.05).3.Comparison of diaphragm movement-related indexes between the two groups:DE in group R had no significant change at three time points,DE in group P was significantly lower than T0 at T1 and T2(P<0.05);DT in both groups was significantly lower at T1 and T2 DTF decreased significantly(P<0.05),but the R group was significantly greater than the P group(P<0.05);the DTF of both groups decreased significantly at T1,and at T2,the P group was still significantly lower than the T0 and R groups(P<0.05).4.Comparison of adverse events between the two groups:the incidences of diaphragmatic inhibition,hypotension,bradycardia and injection pain in group R were significantly lower than those in group P(P<0.05).Conclusion:When remimazolam is used for painless colonoscopy in elderly patients,it has less interference with hemodynamics,and has less inhibition on daphragmatic excursion,daphragm thickness and daphragmatic thickening fraction than propofol.To a certain extent reduce the occurrence of adverse events during painless colonoscopy.