首页|复合舒芬太尼时瑞马唑仑抑制老年患者鼻咽通气道置入反应的半数有效剂量

复合舒芬太尼时瑞马唑仑抑制老年患者鼻咽通气道置入反应的半数有效剂量

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目的 探讨复合舒芬太尼时瑞马唑仑抑制老年患者鼻咽通气道置入反应的半数有效剂量(ED50).方法 选择择期在鼻咽通气道下完成白内障手术的老年患者 38 例,年龄≥65 岁,BMI 18~25 kg/m2,ASAⅠ—Ⅲ级.患者依次静脉注射舒芬太尼 0.1 μg/kg,3 min后静脉注射瑞马唑仑,2 min后置入鼻咽通气道.首例患者给予瑞马唑仑 0.2 mg/kg,采用改良Dixon序贯法确定下一例患者瑞马唑仑的剂量,若前一例患者鼻咽通气道置入时出现以下任意一种阳性反应(摇头、呛咳、体动、HR增快幅度>基础值的20%、SBP或DBP升高幅度>基础值的20%),则下一例麻醉诱导时瑞马唑仑剂量增加0.01 mg/kg,反之则减少0.01 mg/kg,直到出现7 次折返后停止.采用Probit回归分析计算复合舒芬太尼时瑞马唑仑抑制老年患者鼻咽通气道置入反应的ED50、95%有效剂量(ED95)及95%可信区间(CI).结果 复合舒芬太尼时瑞马唑仑抑制鼻咽通气道置入反应的 ED50 为 0.193 mg/kg(95%CI 0.191~0.195 mg/kg),ED95为 0.209 mg/kg(95%CI 0.205~0.213 mg/kg).结论 复合舒芬太尼时瑞马唑仑抑制老年患者鼻咽通气道置入反应的 ED50 为 0.193 mg/kg(95%CI 0.191~0.195 mg/kg).
Median effective dose of remimazolam combined with sufentanil for inhibition of nasopharyngeal airway insertion reaction in elderly patients
Objective To calculate median effective dose(ED50)of remimazolam combined with sufentanil for inhibition of nasopharyngeal airway insertion reaction in elderly patients.Methods Thirty-eight patients,aged≥65 years,BMI 18-25 kg/m2,ASA physical statusⅠ-Ⅲ,undergoing elective cata-ract surgery under nasopharyngeal airway were selected.Patients received intravenous sufentanil injections of 0.1 μg/kg,followed by intravenous remimazolam injection 3 minutes later,then nasopharyngeal airway in-sertion after 2 minutes.The initial dose of remimazolam was 0.2 mg/kg and adjusted by 0.01 mg/kg,based on the modified Dixon sequential method.A positive reaction was defined as head shaking,choking,body movement,an increase in HR>20%of the basal value,or an increase in SBP or DBP>20%of the basal value at the time of nasopharyngeal airway placement.The procedure was stopped after seven crossovers.The ED50,95%effective dose(ED95)of remimazolam,and 95%confidence intervals(CI)were calculated by probabilistic unit(Probit)regression analysis.Results When combined with sufentanil,the ED50 and ED95 of remimazolam for inhibition of nasopharyngeal airway insertion in elderly patients was 0.193 mg/kg(95%CI 0.191-0.195 mg/kg)and 0.209 mg/kg(95%CI 0.205-0.213 mg/kg),respectively.Conclusion The ED50 of remimazolam combined with sufentanil for inhibition of nasopharyngeal airway in-sertion reaction in elderly patients were 0.193 mg/kg(95%CI 0.191-0.195 mg/kg).

RemimazolamMedian effective doseNasopharyngeal airway insertionAged

钱淑雯、郭旋、沈耘、张马忠

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200090 上海市杨浦区中心医院同济大学附属杨浦医院麻醉科

上海交通大学医学院附属上海儿童医学中心麻醉科儿童临床药理研究室

瑞马唑仑 半数有效剂量 鼻咽通气道 老年

2024

临床麻醉学杂志
中华医学会南京分会

临床麻醉学杂志

CSTPCD北大核心
影响因子:2.225
ISSN:1004-5805
年,卷(期):2024.40(1)
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