Department of Anesthesiology, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China.
Ann Palliat Med. 2022 Feb;11(2):568-573. doi: 10.21037/apm-22-89.
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.
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.
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].
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.
苯磺酸瑞马唑仑注射液是一种新型苯二氮䓬类药物。合理选择和正确应用麻醉剂对患者至关重要。本研究旨在确定苯磺酸瑞马唑仑用于无痛结肠镜检查患者麻醉诱导的 90%有效剂量（ED90）。
在 2020 年 12 月至 2021 年 1 月期间，对 112 例行无痛结肠镜检查的患者进行了剂量反应研究。苯磺酸瑞马唑仑的初始剂量为 7.5mg。麻醉师根据改良观察者警觉/镇静评分（MOAA/S）量表评估镇静深度是否满意。如果一位患者的 MOAA/S 评分大于 1 分，则为下一位患者增加 2.5mg 的负荷剂量。如果 MOAA/S 评分为 1 分或更低，则根据 9:1 偏倚硬币设计，为下一位患者维持或减少当前剂量 2.5mg。计算苯磺酸瑞马唑仑用于无痛结肠镜检查的麻醉诱导 ED90。记录苯磺酸瑞马唑仑的不良事件和并发症。
当药物浓度为 1mg/ml，输注速度为 1000ml/h 时，苯磺酸瑞马唑仑用于无痛结肠镜检查的 ED90 为 11.43mg（95%置信区间：9.85-13.02mg）。
健康成年患者行无痛结肠镜检查时，负荷剂量为 12mg 苯磺酸瑞马唑仑可安全、有效、快速诱导患者入睡，并缩短麻醉诱导时间。
