Abstract：Objective: To investigate the safety and efficacy of remimazolam tosilate combined with low-dose esketamine in transendoscopic retrograde cholangiopancreatography (ERCP) of elderly patients.Methods: One hundred and seventy elderly patients undergoing ERCP were randomly separated into group A (86 patients) and group B (84 patients). Group A was anesthetized with remimazolam tosilate combined with low-dose esketamine intravenously, and group B was anesthetized with propofol combined with low-dose sufentanil intravenously. The vital signs indexes at different time points of anesthesia [admission (T0), the moment of endoscopic entry into the laryngopharynx (T1), at cholangiography (T2), at the moment of lithotripsy (T3), at the end of the procedure (T4), and at the time of awakening (T5)] were compared between the two groups, and the MOAA/S scores and adverse reactions were recorded.Results: The mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), partial pressure of arterial oxygen (SPO2) and levels at each time point from T1 to T4 in both groups were greatly lower than those at T0 (P<0.05), and the levels of MAP, HR, RR, and SPO2 were higher in group A than in group B from T1 to T4 (P<0.05). The VAS score of group A after anesthesia was (1.73±0.33), lower than that of group B (2.15±0.38), MOAA/S score was (4.03±0.67), higher than that of group B (3.19±0.53) (t=7.700, 9.052, all P<0.05). Anesthesia recovery time and spontaneous respiration recovery time in group A were (7.40±2.12) min and (6.53±1.62) min, which were earlier than (11.57±3.26) min and (8.70±2.18) min in group B (t=9.910, 7.378, all P<0.05). The incidences of hypotension and bradycardia in group A were lower than those in group B (P<0.05).Conclusion: Compared with propofol combined with low-dose sufentanil, the use of remimazolam tosilate combined with low-dose esketamine has a better safety and efficacy in ERCP in elderly patients, improves the quality of awakening, and produces relatively fewer adverse effects.
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2024, Vol. 30 
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