Pharmacodynamics of remimazolam tosilate inducing loss of consciousness when combined with sufentanil in children
王少超 1王磊 1王超 2赵文 1昝云雷 1李全德 1林晓莉 3葛胜辉
扫码查看
点击上方二维码区域，可以放大扫码查看
作者信息
1. 山东大学附属儿童医院(济南市儿童医院)麻醉科，济南 250022
2. 山东大学附属儿童医院(济南市儿童医院)呼吸介入科，济南 250022
3. 山东大学附属儿童医院(济南市儿童医院)泌尿外科，济南 250022
折叠
摘要
目的 评价复合舒芬太尼时甲苯磺酸瑞马唑仑用于儿童意识消失的药效学。 方法 拟行电子支气管镜检查术患儿，性别不限，年龄3～6岁，ASA分级Ⅰ或Ⅱ级。所有患儿入室后心电监护，缓慢静脉注射舒芬太尼0.1 μg/kg，3 min后静脉注射甲苯磺酸瑞马唑仑。采用Dixon改良序贯法进行试验，甲苯磺酸瑞马唑仑初始剂量为0.30 mg/kg，根据意识是否消失确定下一例患儿甲苯磺酸瑞马唑仑的剂量，相邻剂量梯度为0.05 mg/kg，意识消失标准：甲苯磺酸瑞马唑仑注射完毕1 min后睫毛反射消失且改良警觉/镇静评分达到0分，直至出现8个意识未消失-意识消失的交叉点。采用probit法计算甲苯磺酸瑞马唑仑使儿童意识消失的半数有效剂量(ED50)、95%有效剂量(ED95)及其95%可信区间(95%CI)。 结果 复合舒芬太尼时甲苯磺酸瑞马唑仑使儿童意识消失的ED50及其95%CI为0.461(0.429～0.493) mg/kg，ED95及其95%CI为0.515(0.487～0.689) mg/kg。 结论 复合舒芬太尼时甲苯磺酸瑞马唑仑使儿童意识消失的ED50为0.461 mg/kg，ED95为0.515 mg/kg。 Objective To evaluate the pharmacodynamics of remimazolam tosilate inducing loss of consciousness (LOC) when combined with sufentanil in children. Methods American Society of Anesthesiologists Physical Status classificationⅠ or Ⅱ pediatric patients of either sex, aged 3-6 yr, undergoing electronic bronchoscopy, were included in this study. ECG monitoring was carried out in all children after admission, sufentanil 0.1 μg/kg was intravenously injected slowly, and 3 min later remidazolam tosilate was intravenously injected. The dose of remimazolam tosilate was determined by the modified Dixon′s up-and-down sequential experiment, and the initial dose of remimazolam tosilate was 0.30 mg/kg. The dose of remimazolam tosilate in the next child was determined according to the the loss of consciousness, and the successive dose gradient was 0.05 mg/kg. Loss of eyelash reflex and Modified Observer′s Assessment of Alertness/Sedation Scale score reaching 0 and the occurrence of 8 crossover points where consciousness transitioned from non-disappearance to disappearance after 1 min of remimazolam tosilate injection were considered to be signs of LOC. The median effective dose (ED 50), 95% effective dose (ED95), and their 95% confidence interval (CI) of remimazolam tosilate inducing LOC were calculated using probit method. Results When combined with sufentanil, the ED50 and 95% CI of remimazolam tosilate inducing loss of consciousness were 0.461 (0.429-0.493) mg/kg, and the ED95 and 95% CI were 0.515 (0.487-0.689) mg/kg. Conclusions When combined with sufentanil, the ED50 of remimazolam tosilate inducing LOC is 0.461 mg/kg and the ED95 is 0.515 mg/kg in children.
Abstract
Objective To evaluate the pharmacodynamics of remimazolam tosilate inducing loss of consciousness (LOC) when combined with sufentanil in children. Methods American Society of Anesthesiologists Physical Status classificationⅠ or Ⅱ pediatric patients of either sex, aged 3-6 yr, undergoing electronic bronchoscopy, were included in this study. ECG monitoring was carried out in all children after admission, sufentanil 0.1 μg/kg was intravenously injected slowly, and 3 min later remidazolam tosilate was intravenously injected. The dose of remimazolam tosilate was determined by the modified Dixon′s up-and-down sequential experiment, and the initial dose of remimazolam tosilate was 0.30 mg/kg. The dose of remimazolam tosilate in the next child was determined according to the the loss of consciousness, and the successive dose gradient was 0.05 mg/kg. Loss of eyelash reflex and Modified Observer′s Assessment of Alertness/Sedation Scale score reaching 0 and the occurrence of 8 crossover points where consciousness transitioned from non-disappearance to disappearance after 1 min of remimazolam tosilate injection were considered to be signs of LOC. The median effective dose (ED 50), 95% effective dose (ED95), and their 95% confidence interval (CI) of remimazolam tosilate inducing LOC were calculated using probit method. Results When combined with sufentanil, the ED50 and 95% CI of remimazolam tosilate inducing loss of consciousness were 0.461 (0.429-0.493) mg/kg, and the ED95 and 95% CI were 0.515 (0.487-0.689) mg/kg. Conclusions When combined with sufentanil, the ED50 of remimazolam tosilate inducing LOC is 0.461 mg/kg and the ED95 is 0.515 mg/kg in children.
关键词
舒芬太尼/儿童/剂量效应关系,药物
Key words
Benzodiazepines/Sufentanil/Children/Dose-response relationship, drug
万方数据