The median effective dose of remazolam for painless gastroscopy when combined with lidocaine
Objective The purpose of this study was to investigate the median effective dose(ED50)of remazolam combined with lidocaine during gastroscopy,so as to provide guidance for safe and effective clinical rational application.Method Patients undergoing painless upper gastroscopy at Endoscopy Center of Zhuhai People's Hospital from June 2024 to August 2024 were enrolled.After 2%li-docaine by a throat anesthetic tube,anesthesia process was completed with intravenous injection of remazolam.The initial induction dose of remazolam was set at 0.25mg/kg,with an increase or decrease of 0.02mg/kg depending on the occurrence of a positive reaction,in order to precisely determine the required induction dose for the next patient.After intravenous remazolam,when the heart rate increased to the baseline and the modified observe assessment of alertness/sedation score(MOAA/S)was≤1,the gastroscope was inserted,and when positive reactions such as swallowing,coughing and physical movement occurred,the induced dose of remazolam was increased by 0.02 mg/kg for the next patient.Conversely,the induced dose in the next patient was reduced by 0.02 mg/kg.The study was ended when 7 crossing points appeared.The ED50 and 95%CI of remazolam were calculated by probit regression analysis.Results A total of 31 patients completed the trial.During anesthesia,MAP showed a downward trend(P<0.05),but the decrease was less than 20%,and it could be resolved without treatment.The heart rate increased slightly when the gastroscope was inserted(P<0.05),and there were no patients with hypoxemia.The recovery time of the patient was(11.1±2.2)min.The ED50 and 95%CI of remazolam combined with li-docaine in inhibiting positive reaction of patients during gastroscopy were 0.240mg/kg and 0.194～0.275mg/kg,respectively.Conclu-sion When combined with lidocaine,the ED50 of remazolam in reactions to insertion of endoscopy was 0.240mg/kg.Moreover,it has stable respiratory and circulatory system,and the anesthesia effect is accurate.
万方数据
维普
