Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea.
Office of Biostatics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Korea.
Korean J Anesthesiol. 2022 Dec;75(6):510-517. doi: 10.4097/kja.22331. Epub 2022 Aug 1.
Remimazolam is a new ultra short-acting benzodiazepine originally developed as an improved version of midazolam. Recent studies have demonstrated non-inferiority of remimazolam to propofol in general anesthesia. However, to date, few studies have investigated the induction bolus dose of remimazolam required to achieve general anesthesia. We aimed to determine the 95% effective dose (ED95) of remimazolam bolus required to achieve loss of consciousness (LOC) and the appropriate doses for different age groups.
Patients aged 20-79 years with the American Society of Anesthesiologists physical status of I or II were enrolled in this study. A total of 120 patients were included representing young, middle-aged, and elderly groups. Loss of eyelash reflex and verbal response after the administration of remimazolam was considered successful LOC. The ED95 of remimazolam was determined using a biased coin up-and-down design with sequential allocation and the isotonic regression method.
The ED95 of remimazolam for induction of general anesthesia was 0.367 mg/kg (95% CI [0.277, 0.392]) in the young group, 0.369 mg/kg (95% CI [0.266, 0.394]) in the middle-aged group, and 0.249 mg/kg (95% CI [0.199, 0.288]) in the elderly group. During the study period, none of the patients required rescue medications for hypotension or bradycardia.
This study investigated the ED95 of remimazolam bolus for anesthesia induction. The precise dosing of the ED95 can help maintain hemodynamic stability during the induction of anesthesia.
雷米唑仑是一种新型超短效苯二氮䓬类药物，最初被开发为咪达唑仑的改良版。最近的研究表明，雷米唑仑在全身麻醉中的非劣效性不劣于丙泊酚。然而，迄今为止，很少有研究调查雷米唑仑诱导剂量以达到全身麻醉。我们旨在确定达到意识丧失（LOC）所需的雷米唑仑推注剂量的 95%有效剂量（ED95），以及不同年龄组的适当剂量。
本研究纳入了年龄在 20-79 岁之间、美国麻醉医师协会身体状况为 I 或 II 级的患者。共有 120 名患者被纳入本研究，代表了年轻、中年和老年组。雷米唑仑给药后睫毛反射和言语反应丧失被认为是成功的 LOC。ED95 采用偏倚硬币上下设计、序贯分配和等张回归方法确定。
雷米唑仑诱导全身麻醉的 ED95 为 0.367mg/kg（95%CI[0.277，0.392]）在年轻组，0.369mg/kg（95%CI[0.266，0.394]）在中年组，0.249mg/kg（95%CI[0.199，0.288]）在老年组。在研究期间，没有患者需要使用升压药或降压药来治疗低血压或心动过缓。
本研究调查了雷米唑仑推注用于麻醉诱导的 ED95。ED95 的精确剂量可以帮助维持麻醉诱导期间的血液动力学稳定性。
