【原】【罌粟摘要】上下測定苯磺酸瑞馬唑侖麻醉誘導(dǎo)的90%有效劑量（ED90）

罌粟花anesthGH 2022-04-17

展開全文

上下測定苯磺酸瑞馬唑侖麻醉誘導(dǎo)的90%有效劑量（ED90）

貴州醫(yī)科大學(xué) 麻醉與心臟電生理課題組

翻譯：吳學(xué)艷編輯：潘志軍審校：曹瑩

BLUE SKY

背景：

注射用苯磺酸瑞馬唑侖是一種新型苯二氮卓類藥物；合理選擇和正確應(yīng)用麻醉劑對患者至關(guān)重要。本研究旨在確定苯磺酸瑞馬唑侖用于患者行無痛結(jié)腸鏡檢查時麻醉誘導(dǎo) 90%有效劑量(ED90)。

方法：

在 2020年 12月至 2021年 1月期間,，共納入112名接受無痛結(jié)腸鏡檢查的患者進(jìn)行劑量-反應(yīng)研究；瑞馬唑侖的初始劑量為 7.5 mg，麻醉醫(yī)生采用改良警覺鎮(zhèn)靜評估量表(MOAA/S)評估鎮(zhèn)靜深度是否達(dá)到滿意,。如果一名患者的 MOAA/S 評分 > 1分，則下一名患者的負(fù)荷劑量增加 2.5 mg,；如果 MOAA/S 評分≤1 分,，則根據(jù) 9:1 偏向硬幣設(shè)計(jì)法，為下一位患者維持當(dāng)前劑量或減少2.5 mg,；計(jì)算苯磺酸瑞馬唑侖用于無痛結(jié)腸鏡檢查的麻醉誘導(dǎo)ED90劑量,，并記錄苯磺酸瑞馬唑侖的不良事件和并發(fā)癥。

結(jié)果：

當(dāng)藥物濃度為1 mg/ml,，輸注速度為1000ml/h時,，苯磺酸瑞馬唑侖用于無痛結(jié)腸鏡檢查的ED90為11.43 mg[95%（CI）：9.85-13.02 mg]。

BLUE SKY

結(jié)論：

健康成人患者接受無痛結(jié)腸鏡檢查時,，負(fù)荷劑量為12 mg的苯磺酸瑞馬唑侖可安全,、有效、快速地誘導(dǎo)患者入睡,，縮短麻醉誘導(dǎo)時間,。

原始文獻(xiàn)來源：

Lu Z, Zhou N, Li Y, et al. Up-down determination of the 90% effective dose (ED90) of remimazolam besylate for anesthesia induction. Ann Palliat Med[J]. 2022 Feb;11(2):568-573. DOI: 10.21037/apm-22-89.

英文原文

Up-down determination of the 90% effective dose (ED90) of remimazolam besylate for anesthesia induction

Abstract

Background: Remimazolam besylate for injection is a novel benzodiazepine. Reasonable selection and proper application of anesthetics is critical for patients. This study aims to determine the 90% effective dose (ED90) of remimazolam besylate for anesthesia induction in patients undergoing painless colonoscopy.

Methods: A dose-response study was carried out in 112 patients undergoing painless colonoscopy between December 2020 and January 2021. The initial dose of remimazolam was 7.5 mg. The anesthesiologist assessed whether the depth of sedation was satisfactory according to the Modified Observer's Assessment of Alertness and Sedation (MOAA/S) scale. If the MOAA/S score of one patient was >1 point, the loading dose for the next patient was increased by 2.5 mg. If the MOAA/S score was ≤1 point, the current dose was maintained or reduced by 2.5 mg for the next patient according to a 9:1 biased coin design. The ED90 of remimazolam besylate for anesthesia induction for painless colonoscopy was calculated. The adverse events and complications of remimazolam besylate were recorded.

Results: When the drug concentration was 1 mg/mL and the infusion rate was 1,000 mL/h, the ED90 of remimazolam besylate for painless colonoscopy was 11.43 mg [95% confidence interval (CI): 9.85-13.02 mg].

Conclusions: A loading dose of 12 mg remimazolam besylate for healthy adult patients undergoing painless colonoscopy can safely, effectively, and quickly induce patients to fall asleep and shorten the anesthesia induction time.