Interventions
hypotension
All patients were routinely monitored for ECG, oxygen saturation, and blood pressure after entering the endoscopy room (left lateral position, sphygmomanometer cuff tied to the right hand), given nasal catheter oxygen (4 L/minutes), fentanyl (0.5 μg/kg, Yichang Renfu, China) was first administered intravenously 4 minutes in advance, and infused within 1 minute, followed by the administration of the test drug (test drug administration time was 1 minute): remimazolam tosylate (RT group, 0.2 mg/kg, Jiangsu Hengrui) or propofol (P group, 2 mg/kg, AstraZeneca, UK) or remimazolam tosylate combined with propofol group (R+P group, remimazolam tosylate 0.1 mg/kg + propofol 0.5 mg/kg) for sedation induction, and the examination began after the patients achieved sufficient sedation (MOAA/S score ≤1). During the procedure, the evaluation investigator instructed the dosing investigator to administer the appropriate sedative medication for sedation maintenance based on the MOAA/S score. The examination was initiated when patients achieved adequate sedation; if patients had a MOAA/S score >1 or a MOAA/S score ≤1 but failed to attempt the examination, additional administration of the appropriate sedative drug was allowed 1 minute after the end of the initial dose (RT group: remimazolam tosylate 2.5 mg/dose; P group: propofol 0.5 mg/kg; R+P group: propofol 0.5mg/kg).Atropine 0.5mg was administered intravenously if the heart rate was less than 45 beats per minute during the examination. When mean arterial pressure (MAP) is less than 70% preoperatively (i.e. hypotension requiring treatment), intravenous rapidly administered crystalloid fluid 200 ml, if blood pressure is still less than 70% preoperatively after volume replenishment, ephedrine 5–10 mg/time can be injected and recorded. The patient is on continuous oxygen during the examination, if pulse oximetry (SpO