Abstract：
OBJECTIVE: To investigate the impacts of remimazolam tosilate on gastrointestinal hormones and motility in patients undergoing gastrointestinal endoscopy with sedation.
METHODS: A total of 262 American Society of Anesthesiologists Physical Status I or II patients, aged 18-65 years, scheduled for gastrointestinal endoscopy with sedation, were randomly allocated into two groups (n = 131 each): the remimazolam tosilate group (Group R) and the propofol group (Group P). Patients in Group R received 0.2-0.25 mg/Kg remimazolam tosilate intravenously, while those in Group P received 1.5-2.0 mg/kg propofol intravenously. The gastrointestinal endoscopy was performed when the Modified Observer\'s Assessment of Alertness/Sedation scores were ≤3. The primary endpoints included the endoscopic intestinal peristalsis rating by the endoscopist; serum motilin and gastrin levels at fasting without gastrointestinal preparation (T0), before gastrointestinal endoscopy (T1), and before leaving the Post Anesthesia Care Unit (T2); and the incidences of abdominal distension during Post Anesthesia Care Unit.
RESULTS: Compared with Group P, intestinal peristalsis rating was higher in Group R (P < .001); Group R showed increased motilin and gastrin levels at T2 compared with Group P (P < .01). There was a rise in motilin and gastrin levels at T1 and T2 compared with T0 and at T2 compared with T1 in both groups (P < .01). The incidence of abdominal distension was lower in Group R (P < .05).
CONCLUSIONS: Compared with propofol used during gastrointestinal endoscopy with sedation, remimazolam tosilate mildly inhibits the serum motilin and gastrin levels, potentially facilitating the recovery of gastrointestinal motility.
METHODS: A total of 262 American Society of Anesthesiologists Physical Status I or II patients, aged 18-65 years, scheduled for gastrointestinal endoscopy with sedation, were randomly allocated into two groups (n = 131 each): the remimazolam tosilate group (Group R) and the propofol group (Group P). Patients in Group R received 0.2-0.25 mg/Kg remimazolam tosilate intravenously, while those in Group P received 1.5-2.0 mg/kg propofol intravenously. The gastrointestinal endoscopy was performed when the Modified Observer\'s Assessment of Alertness/Sedation scores were ≤3. The primary endpoints included the endoscopic intestinal peristalsis rating by the endoscopist; serum motilin and gastrin levels at fasting without gastrointestinal preparation (T0), before gastrointestinal endoscopy (T1), and before leaving the Post Anesthesia Care Unit (T2); and the incidences of abdominal distension during Post Anesthesia Care Unit.
RESULTS: Compared with Group P, intestinal peristalsis rating was higher in Group R (P < .001); Group R showed increased motilin and gastrin levels at T2 compared with Group P (P < .01). There was a rise in motilin and gastrin levels at T1 and T2 compared with T0 and at T2 compared with T1 in both groups (P < .01). The incidence of abdominal distension was lower in Group R (P < .05).
CONCLUSIONS: Compared with propofol used during gastrointestinal endoscopy with sedation, remimazolam tosilate mildly inhibits the serum motilin and gastrin levels, potentially facilitating the recovery of gastrointestinal motility.
摘要：
目的：探讨甲磺酸瑞米唑仑对胃肠镜检查患者胃肠激素及运动功能的影响。
方法：总共262名美国麻醉医师协会体格状态I或II的患者，18-65岁,计划进行胃肠内窥镜检查并进行镇静，随机分为两组（每组n=131）：甲苯磺酸瑞米唑仑组（R组）和异丙酚组（P组）。R组患者静脉内接受0.2-0.25mg/Kg甲苯磺酸瑞咪唑安定，而P组患者静脉注射丙泊酚1.5~2.0mg/kg.当改良观察者的警觉/镇静评估评分≤3时，进行胃肠内镜检查。主要终点包括内镜医师的内镜肠蠕动评分；空腹时无胃肠道准备（T0）的血清胃动素和胃泌素水平，胃肠内镜检查前（T1），以及离开麻醉后护理室（T2）之前；以及麻醉后护理室期间腹胀的发生率。
结果：与P组相比，R组的肠蠕动评分较高（P<.001）；与P组相比，R组T2时胃动素和胃泌素水平升高（P<.01）。两组在T1和T2时胃动素和胃泌素水平均高于T0，在T2时高于T1（P<0.01）。R组腹胀发生率较低(P<0.05)。
结论：与在胃肠镜检查过程中使用丙泊酚镇静相比，甲苯磺酸瑞米唑仑轻度抑制血清胃动素和胃泌素水平，可能促进胃肠蠕动的恢复。
方法：总共262名美国麻醉医师协会体格状态I或II的患者，18-65岁,计划进行胃肠内窥镜检查并进行镇静，随机分为两组（每组n=131）：甲苯磺酸瑞米唑仑组（R组）和异丙酚组（P组）。R组患者静脉内接受0.2-0.25mg/Kg甲苯磺酸瑞咪唑安定，而P组患者静脉注射丙泊酚1.5~2.0mg/kg.当改良观察者的警觉/镇静评估评分≤3时，进行胃肠内镜检查。主要终点包括内镜医师的内镜肠蠕动评分；空腹时无胃肠道准备（T0）的血清胃动素和胃泌素水平，胃肠内镜检查前（T1），以及离开麻醉后护理室（T2）之前；以及麻醉后护理室期间腹胀的发生率。
结果：与P组相比，R组的肠蠕动评分较高（P<.001）；与P组相比，R组T2时胃动素和胃泌素水平升高（P<.01）。两组在T1和T2时胃动素和胃泌素水平均高于T0，在T2时高于T1（P<0.01）。R组腹胀发生率较低(P<0.05)。
结论：与在胃肠镜检查过程中使用丙泊酚镇静相比，甲苯磺酸瑞米唑仑轻度抑制血清胃动素和胃泌素水平，可能促进胃肠蠕动的恢复。
