Application effect of remifentanil combined with remimazolam in non-intubated general anesthesia fiberoptic bronchoscopy with preserved spontaneous breathing

Objective To explore the application effect of remimazolam combined with remifentanil in non-intubated general anesthesia fiberoptic bronchoscopy with preserved spontaneous breathing and its influence on hemodynamic indicators.

Methods A total of 114 non-intubated general anesthesia fiberoptic bronchoscopy patients with preserved spontaneous breathing were selected and randomly divided into control group and trial group, with 57 cases in each group. The control group was intravenously dripped with 30 μg dexmedetomidine and slowly injected with 1 to 3 μg/kg remifentanil, while the trial group was intravenously injected with 0.2 mg/kg remimazolam on the basis of the control group. The heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation (SpO₂) were compared between the two groups at the time points of before bronchoscopy (T₀), immediately entering the trachea (T₁) and 3 minutes after bronchoscopy (T₂); the levels of NOD-like receptor thermal protein domain associated protein 3 (NLRP3), apoptosis-related speckle-like protein(ASC), interleukin-1β (IL-1β) and interleukin-1 (IL-1) were observed at T₀ and T₂; the anesthesia and adverse reactions in both groups were recorded.

Results From T₀ to T₂, the increasing and decreasing degrees of HR, MAP and SpO₂ levels in the trial group were significantly smaller than those in the control group (P < 0.05); at T₂, the NLRP3, ASC, IL-1β and IL-1 levels in the trial group were significantly lower than those in the control group (P < 0.05). The induction anesthesia time and the time of leaving the room in the trial group were significantly shorter than those in the control group, the excellent and good rate of anesthesia was significantly higher than that in the control group, and the incidence of adverse reactions was significantly lower than that in the control group (P < 0.05).

Conclusion In non-intubated general anesthesia fiberoptic bronchoscopy patients with preserved spontaneous breathing, remimazolam combined with remifentanil can inhibit the releases of inflammatory factors, stabilize the levels of hemodynamic indicators and reduce the incidence of adverse reactions.