ABSTRACT
INTRODUCTION: Further clinical validation is required to determine whether transcutaneous electrical acupoint stimulation (TEAS) can replace opioids and be used in combination with remimazolam for sedation during gastrointestinal endoscopy. METHODS: A total of 108 outpatients who underwent diagnostic gastrointestinal endoscopy were randomly divided into three groups: fentanyl plus remimazolam group (group C), TEAS plus remimazolam group (group E), and placebo-TEAS plus remimazolam group (group P). The assessments of patient satisfaction, physician satisfaction, and pain scale score during the examination constituted the primary endpoints of the study. The secondary endpoints were the time of recovery, recovery of normal behavioral function and discharge, incidence of adverse reactions, and dose of remimazolam. RESULTS: Compared with group C, group E had a greater median score for patient satisfaction at follow-up and a slightly lower median score for physician satisfaction. The pain score of group E was slightly greater than that of group C, but the difference was not significant. However, in group C, the incidence of hypoxemia, the rate of nausea and the severity of vertigo were greater, and the number of patients discharged and resuming normal behavioral function was greater than those in the other two groups. The dose of remimazolam in group C and group E was less than that in group P. CONCLUSIONS: TEAS combined with moderate sedation of remimazolam can provide an ideal sedative effect, which preferably suppresses discomfort caused by gastrointestinal endoscopy and has fewer sedation-related complications. TRIAL REGISTRATION: ID: NCT05485064; First registration (29/07/2022); Last registration (02/11/2022) (Clinical Trials.gov).
ABSTRACT
Objective:To explore influence of tirofiban on plasma level of growth differentiation factor-15(GDF-15) and serum level of platelet activating factor(PAF)in patients with acute myocardial infarction(AMI)undergoing percutaneous coronary intervention(PCI).Methods:A total of 110 AMI patients undergoing emergency PCI from Jan 2015 to Dec 2016 were selected.According to random number table,they were randomly and equally divided in-to routine treatment group(received dual antiplatelet therapy etc.)and tirofiban group(received tirofiban based on routine treatment group).TIMI blood flow grade and cardiac function after PCI,plasma GDF-15 and serum PAF levels before and after treatment,and incidence of adverse events were compared between two groups.Results:Compared with routine treatment group on 7d after PCI,there were significant reductions in serum PAF level [(10.2 ± 1.7)μg/L vs.(8.3 ± 1.4)μg/L]and plasma GDF-15 level[(2.6 ± 0.8)μg/L vs.(1.5 ± 0.6)μg/L]in tirofiban group,P=0.001 both.Compared with routine treatment group on six months after PCI,there was signifi-cant rise in left ventricular ejection fraction[(52.8 ± 6.6)% vs.(57.5 ± 7.3)%],and significant reductions in left ventricular end-systolic dimension[(45.4 ± 7.1)mm vs.(40.2 ± 6.9)mm],left ventricular end-diastolic dimension [(57.0 ± 7.2)mm vs.(52.4 ± 7.6)mm]and incidence rate of adverse events(14.5% vs.1.8%)in tirofiban group,P<0.05 or <0.01. Conclusion:Compared with routine treatment,tirofiban can more significantly reduce plasma GDF-15 and serum PAF levels,improve cardiac function in AMI patients after PCI,and it′s safe,which is worth extending.