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异丙酚、环丙酚和瑞马唑仑对胃肠内镜检查麻醉期间做梦的影响：随机双盲平行设计试验
贵州医科大学 麻醉与心脏电生理课题组
翻译：王璐 编辑：田明德 审校：曹莹
目的：比较异丙酚、环丙酚和瑞马唑仑对无痛胃肠镜检查时做梦的影响。
方法：这项研究是一个单中心、前瞻性、平行设计、双盲、随机临床试验。在2023年5月至2023年10月期间，招募了计划进行无痛胃肠道内窥镜检查的患者，并随机分配到三个组中的一个。收集了人口统计数据、手术信息、做梦发生率、术中知晓、梦境类型、患者满意度评分、不良事件以及睡眠质量的改善情况。
结果：三组做梦发生率无显著性差异（33.33% vs 48.33% vs 41.67%， p =0.061）。异丙酚组术中发生低血压的患者数量多于瑞马唑仑组（32 vs 12， p =0.001）。然而，丙泊酚组与环丙酚组相比及环丙酚组与瑞马唑仑组相比术中发生低血压的患者数量无显著性差异（32 vs 22， p = 0.122；22 vs 12， p = 0.064）。丙泊酚组与瑞马唑仑组术中知晓比例差异有统计学意义（13.33% vs 1.67%， p=0.001），而丙泊酚组与瑞马唑仑组相比及环丙酚组与瑞马唑仑组相比术中知晓比例无统计学差异（p = 0.025；5.00% vs 1.67%， p = 0.150）。丙泊酚组胃肠镜检查后第1天睡眠质量改善显著优于瑞马唑仑组（86.21% vs 72.88%， p =0.015），而丙泊酚组与环丙酚组相比、环丙酚组与瑞马唑仑组相比胃肠镜检查后第1天睡眠质量改善情况无显著性差异（86.21% vs 80.36%， p = 0.236；72.88% vs 72.88%， p = 0.181）。术中知晓、术中缺氧、梦的类型、满意度评分、恢复期间的不良事件以及胃肠镜检查后第7天的睡眠质量改善在各组之间并不显著。
结论：胃肠镜检查时分别使用丙泊酚、环丙酚和瑞马唑仑进行麻醉，虽然都容易诱发美梦，但做梦发生率并没有统计学差异。
原始文献来源：Zhou R,Fu L,Liu S, et al. Influences of Propofol, Ciprofol and Remimazolam on Dreaming During Anesthesia for Gastrointestinal Endoscopy: A Randomized Double-Blind Parallel-Design Trial. Drug Des Devel Ther. 2024;18:1907-1915.
Influences of Propofol, Ciprofol and Remimazolam on Dreaming During Anesthesia for Gastrointestinal Endoscopy: A Randomized Double-Blind Parallel-Design Trial
Purpose: To compare the influences of propofol, ciprofol and remimazolam on dreaming during painless gastrointestinal endoscopy.
Methods: This study was a single-center, prospective, parallel-design, double-blind, randomized clinical trial. Between May 2023 and October 2023, patients undergoing elective painless gastrointestinal endoscopy were recruited and randomly allocated into one of the three groups. Demographic data, intraoperative information, incidence of dreaming, insufficient anesthesia and intraoperative awareness, type of dream, patient satisfaction score, adverse events, and improvement of sleep quality were collected.
Results: The difference in incidence of dreaming among the three groups was not significant (33.33% vs 48.33% vs 41.67%, p=0.061). The number of patients with intraoperative hypotension in the propofol group was larger than that of the remimazolam group (32 vs 12, p=0.001). However, the cases of intraoperative hypotension between propofol group and ciprofol group or ciprofol group and remimazolam group were comparable (32 vs 22, p=0.122; 22 vs 12, p=0.064). The percentage of insufficient anesthesia between propofol group and remimazolam group was significant (13.33% vs 1.67%, p=0.001), while no statistical difference was detected between propofol group and remimazolam group or ciprofol group and remimazolam group (13.33% vs 5.00%, p=0.025; 5.00% vs 1.67%, p=0.150). The ability of propofol to improve sleep quality at 1st post-examination day was significantly better than that of remimazolam (86.21% vs 72.88%, p=0.015), while it was not significant between propofol group and ciprofol group or ciprofol group and remimazolam group (86.21% vs 80.36%, p=0.236; 72.88% vs. 72.88%, p=0.181). Incidence of intraoperative awareness, intraoperative hypoxia, type of dream,satisfaction score, adverse events during recovery, and sleep improvement on the 7th post
examination day was not significant among the groups.
Conclusion: Anesthesia with propofol, ciprofol and remimazolam, respectively, for gastrointestinal endoscopy did not induce statistical difference in the incidence of dreaming, despite that all of them are more likely to induce pleasant dreams.
