目的 探讨瑞马唑仑或丙泊酚复合阿芬太尼静脉麻醉在无痛胃肠镜检查中的应用价值。方法 选取2023年1月—2025年1月于湖北省丹江口市第一医院进行无痛胃肠镜检查的100例患者,依据麻醉方案的差异性分为两组,每组各50例。对照组予以丙泊酚复合阿芬太尼麻醉,观察组予以瑞马唑仑复合阿芬太尼麻醉,进行生命体征指标[收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SpO₂）]、临床指标（麻醉诱导时间、检查时间、苏醒时间）以及不良反应情况的比较。结果 实施不同静脉麻醉方案后,相较于对照组,观察组患者在检查开始后5 min（T2）、检查结束时（T3）的SBP、DBP及HR值,以及T2时的SpO₂值均更稳定;麻醉诱导、检查、苏醒时间均更短,且不良反应总发生率更低（P<0.05。）结论 对于无痛胃肠镜检查,瑞马唑仑复合阿芬太尼进行静脉麻醉的应用价值更高,值得推鉴。

Objective To evaluate the value of intravenous anesthesia with remimazolam or propofol combined with alfentanil in painless gastrointestinal endoscopy. Methods A total of 100 patients who underwent painless gastrointestinal endoscopy at the First Hospital of Danjiangkou City, Hubei Province were randomly selected from January 2023 to January 2025. According to anesthesia regimens, they were divided into two groups, with 50 cases in each group. The control group was given intravenous anesthesia with propofol combined with alfentanil, while the observation group was administered intravenous anesthesia with remimazolam combined with alfentanil. The vital signs [systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR）, and blood oxygen saturation （SpO₂）], clinical indicators （anesthesia induction time, examination time, and awakening time）, and adverse reactions were compared between the two groups. Results After implementing different intravenous anesthesia regimens, the SBP, DBP, and HR values at 5 min of examination （T2） and at the end of examination （T3）, as well as the SpO₂ at T2, were more stable in the observation group than those in the control group. The anesthesia induction time, examination time, and awakening time were shorter, and the overall incidence of adverse reactions was lower in the observation group than in the control group （P<0.05）. Conclusion For painless gastrointestinal endoscopy, the use of remimazolam combined with alfentanil for intravenous anesthesia has a high application value and is worth promoting.