{"title":"在持续气道正压下为一名接受消化道内窥镜检查的病态肥胖患者联合使用雷马唑仑和雷米芬太尼进行手术镇静和镇痛：病例报告","authors":"Chih-Wei Lin, Kuang-I Cheng, Zhi-Fu Wu","doi":"10.4103/jmedsci.jmedsci_280_23","DOIUrl":null,"url":null,"abstract":"\n Sedation in patients with morbid obesity undergoing gastrointestinal endoscopy (GIE) frequently causes respiratory depression. Remimazolam, a gamma-aminobutyric acid receptor agonist, is safer than propofol as it has fewer cardiovascular and respiratory adverse effects. We report a case of successful GIE under sedation and analgesia with a combination of remimazolam and remifentanil, respectively, in a patient with morbid obesity experiencing obstructive sleep apnea (OSA). Remimazolam ensured safe sedation, preventing complications such as respiratory depression and hypotension. Dose adjustment of remifentanil can minimize its adverse effects. Therefore, the combination of remimazolam and remifentanil is a promising choice for performing GIE in patients with morbid obesity and OSA.","PeriodicalId":16486,"journal":{"name":"Journal of Medical Sciences","volume":" 8","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Combination of Remimazolam and Remifentanil for Procedural Sedation and Analgesia in a Patient with Morbid Obesity Undergoing Gastrointestinal Endoscopy under Continuous Positive Airway Pressure: A Case Report\",\"authors\":\"Chih-Wei Lin, Kuang-I Cheng, Zhi-Fu Wu\",\"doi\":\"10.4103/jmedsci.jmedsci_280_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n Sedation in patients with morbid obesity undergoing gastrointestinal endoscopy (GIE) frequently causes respiratory depression. Remimazolam, a gamma-aminobutyric acid receptor agonist, is safer than propofol as it has fewer cardiovascular and respiratory adverse effects. We report a case of successful GIE under sedation and analgesia with a combination of remimazolam and remifentanil, respectively, in a patient with morbid obesity experiencing obstructive sleep apnea (OSA). Remimazolam ensured safe sedation, preventing complications such as respiratory depression and hypotension. Dose adjustment of remifentanil can minimize its adverse effects. Therefore, the combination of remimazolam and remifentanil is a promising choice for performing GIE in patients with morbid obesity and OSA.\",\"PeriodicalId\":16486,\"journal\":{\"name\":\"Journal of Medical Sciences\",\"volume\":\" 8\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-04-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Medical Sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/jmedsci.jmedsci_280_23\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical Sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/jmedsci.jmedsci_280_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
病态肥胖患者在接受消化道内窥镜检查（GIE）时，镇静剂经常会导致呼吸抑制。雷马唑仑是γ-氨基丁酸受体激动剂，比丙泊酚更安全，因为它对心血管和呼吸系统的不良反应更少。我们报告了一例分别使用雷马唑仑和瑞芬太尼进行镇静和镇痛的 GIE 成功病例，患者患有阻塞性睡眠呼吸暂停 (OSA)，属于病态肥胖。雷美唑仑可确保安全镇静，防止出现呼吸抑制和低血压等并发症。调整瑞芬太尼的剂量可将其不良反应降至最低。因此，在对病态肥胖和OSA患者进行GIE时，联合使用雷美唑仑和瑞芬太尼是一种很有前景的选择。
Combination of Remimazolam and Remifentanil for Procedural Sedation and Analgesia in a Patient with Morbid Obesity Undergoing Gastrointestinal Endoscopy under Continuous Positive Airway Pressure: A Case Report
Sedation in patients with morbid obesity undergoing gastrointestinal endoscopy (GIE) frequently causes respiratory depression. Remimazolam, a gamma-aminobutyric acid receptor agonist, is safer than propofol as it has fewer cardiovascular and respiratory adverse effects. We report a case of successful GIE under sedation and analgesia with a combination of remimazolam and remifentanil, respectively, in a patient with morbid obesity experiencing obstructive sleep apnea (OSA). Remimazolam ensured safe sedation, preventing complications such as respiratory depression and hypotension. Dose adjustment of remifentanil can minimize its adverse effects. Therefore, the combination of remimazolam and remifentanil is a promising choice for performing GIE in patients with morbid obesity and OSA.
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