瑞马唑仑和丙泊酚用于宫腔镜检查术镇静效应的相互作用
Interaction between remimazolam and propofol for sedation during hysteroscopy
姬乐婷 1郝佩佩 1丁宁 1杜宁宁 1朱广超 1李长生 1魏晓永1
作者信息
- 1. 郑州大学第三附属医院麻醉科,郑州 450052
- 折叠
摘要
目的 评价瑞马唑仑和丙泊酚用于宫腔镜检查术镇静效应的相互作用.方法 拟行宫腔镜检查术患者,年龄20～45岁,BMI 18～28 kg/m2,ASA分级Ⅰ或Ⅱ级,试验分两步进行,用序贯法确定A组(瑞马唑仑)和B组(丙泊酚)的半数有效剂量(ED50);以A组和B组获得的ED50为标准确定C组(0.25×瑞马唑仑ED50+0.75x丙泊酚ED50为起始剂量)、D组(0.5x瑞马唑仑ED50+0.5×丙泊酚ED50为起始剂量)和E组(0.75×瑞马唑仑ED50+0.25×丙泊酚ED50为起始剂量)复合用药方案,用序贯法确定C组、D组和E组丙泊酚和瑞马唑仑复合用药时丙泊酚的ED50.采用等辐射分析法分析两药镇静效应的相互作用,计算相互作用系数及两者协同作用剂量配比.结果 A组瑞马唑仑ED50为0.180 mg/kg,B组丙泊酚ED50为 1.167 mg/kg,等辐射分析结果显示,瑞马唑仑和丙泊酚具有协同作用,当瑞马唑仑0.045、0.090、0.135 mg/kg与丙泊酚0.546、0.288、0.160 mg/kg复合使用时,相互作用系数分别为:1.393、1.339、1.127,瑞马唑仑和丙泊酚协同作用剂量配比为1.0:(3.2～12.0).结论 瑞马唑仑和丙泊酚用于宫腔镜检查术的镇静效应具有协同作用,剂量配比为1.0:(3.2～12.0).
Abstract
Objective To evaluate the interaction between remimazolam and propofol for sedation during hysteroscopy.Methods American Society of Anesthesiologists Physical Status classification Ⅰ orⅡ patients,aged 20-45 yr,with body mass index of 18-28 kg/m2,scheduled for elective hysteroscopy,were included.The test was conducted in two steps.Up-and-down sequential allocation was used to deter-mine the median effective dose(ED50)of remimazolam(group A)and propofol(group B).The ED50 ob-tained in A and B groups were then used as the standard to determine the combination regimen in group C(0.25×ED50 of remimazolam+0.75×ED50 of propofol as the initial dose),in group D(0.5×ED50 of remima-zolam+0.5×ED50 of propofol as the initial dose),and in group E(0.75×ED50 of remimazolam+0.25×ED50 of propofol as the initial dose).Up-and-down sequential allocation was used to determine the ED50 of propofol when propofol and remimazolam were combined in C,D and E groups.The interaction between the sedative effects of two drugs was analyzed using the isobolographic analysis method,and the interaction coefficient and synergistic dose ratio of two drugs were calculated.Results The ED50 of remimazolam was 0.180 mg/kg in group A,and the ED50 of propofol was 1.167 mg/kg in group B.The results of isobolographic analysis showed that remimazolam and propofol had a synergistic effect.When remimazolam 0.045,0.090 and 0.135 mg/kg were combined with propofol 0.546,0.288 and 0.160 mg/kg,the interaction coefficients were 1.393,1.339 and 1.127 respectively.The synergistic dosage ratio of remimazolam and propofol was 1.0:(3.2 to 12.0).Conclusions Remimazolam and propofol have a synergistic effect on sedation when used for hyste-roscopy,and the dose ratio is 1.0:(3.2-12.0).
关键词
苯二氮类/二异丙酚/宫腔镜检查/催眠药和镇静药/药物相互作用Key words
Benzodiazepines/Propofol/Hysteroscopy/Hypnotics and sedatives/Drug in-teractions引用本文复制引用
出版年
2024
NETL
NSTL
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