Abstract
Background: The appropriate doses of remimazolam combined with remifentanil were investigated in anesthesia gastroscopy by observing the effect of two methods of administration in fixed doses and dosed by ideal weight on success rate and recover effect in painless gastroscopy. Methods: A total of 400 patients underwent the anesthesia of gastroscopy were randomized to divide into five groups (W1, W2, F1, F2 and C Group) in endoscopy center, with 80 cases in each group. All patients were given 0.25ug/kg of remifentanil before gastroscopy. The success rate, the quality of anesthesia resuscitation, heart rate, blood pressure, Pulse oxygen saturation, perioperative adverse events and Modified observer’ s assessment of alert/sedation (MOAA/S) diachronic changes were recorded. Results: In terms of anesthetic effects of the first dose of the drug(P<0.05), the patients in F1 group showed be lack of sedation obviously. The success rate of induction in F2 group was higher than that in F1 group. The success rate of sedation in W2 groups was highest (96%). The control group was second to W2 Group. Blood pressure in W2 Group was lower than W1 Group after first administration(P<0.05). There was no significant difference in next several minutes. There was no difference in blood pressure between W2 Group and C Group at T1(P>0.05). There was no difference in the changes of heart rate, recovery time and discharge time(P>0.05). The incidence of cough in F1 and W1 is high(P<0.05). Conclusions: Remimazolam combined with remifentanil used were safe, and 0.3mg/kg of remimazolam combined with 0.25ug/kg of remifentanil by ideal body weight is better in painless gastroscopy.Trial registration: The trial was registered on ClinicalTrials.gov: ChiCTR2100041759, registered 4 January 2021.