Department of Anesthesiology, Zhuji Central Hospital, Zhuji, Zhejiang, China.
Department of Anesthesiology, Zhuji People's Hospital, Zhuji, Zhejiang, China.
Indian J Pharmacol. 2024 Jan 1;56(1):10-15. doi: 10.4103/ijp.ijp_425_22. Epub 2024 Mar 8.
The objectives of this study were to explore the median effective dose (ED50) and the dose required for successful anesthesia in 95% of the patients (ED95) of remimazolam for intravenous anesthesia in adult outpatients undergoing gastroscopy.
This pilot study was conducted in patients scheduled to undergo painless gastroscopy at the authors' hospital between March 15, 2022 and March 25, 2022. The ED of remimazolam was determined using the modified Dixon sequential method, using an initial induction dose of 0.2 mg/kg. With successful or failed anesthesia, the remimazolam dose was decreased or increased by 0.05 mg/kg for the next patient, respectively.
Twenty-two patients (43.6 ± 10.5 years of age) were enrolled. During gastroscopy, the remimazolam induction dose was 19.93 ± 2.96 mg (0.2-0.45 mg/kg). Eighteen patients could complete anesthesia with remimazolam alone, and four patients needed propofol to complete anesthesia. The induction time after the injection of remimazolam was 20.8 ± 8.4 s, the gastroscopy time was 5.1 ± 1.3 min, and the anesthesia recovery time was 17.5 ± 5.6 min. The ED50 and the ED95 of remimazolam were 0.362 mg/kg (95% confidence interval [CI]: 0.313-0.455 mg/kg) and 0.464 mg/kg (95% CI: 0.403-2.242 mg/kg), respectively. The vital signs of all patients remained within the predefined acceptable limits. No patients required antagonist rescue.
The ED50 and ED95 of remimazolam for adult gastroscopy were 0.362 mg/kg and 0.464 mg/kg, respectively. Additional anesthetics might be required during gastroscopy in some patients.
The trial was registered. The number is ChiCTR2200057446.
本研究旨在探讨成人门诊胃镜检查患者静脉应用 remimazolam 麻醉的半数有效剂量（ED50）和 95%患者麻醉成功所需剂量（ED95）。
本研究为前瞻性单中心试验，纳入 2022 年 3 月 15 日至 3 月 25 日在作者医院行无痛胃镜检查的患者。采用改良 Dixon 序贯法，初始诱导剂量为 0.2mg/kg，确定 remimazolam 的 ED。根据麻醉成功或失败，下一个患者的 remimazolam 剂量分别减少或增加 0.05mg/kg。
共纳入 22 例患者（年龄 43.6±10.5 岁）。胃镜检查时，remimazolam 诱导剂量为 19.93±2.96mg（0.2-0.45mg/kg）。18 例患者单用 remimazolam 即可完成麻醉，4 例患者需要丙泊酚完成麻醉。 remimazolam 注射后诱导时间为 20.8±8.4s，胃镜检查时间为 5.1±1.3min，麻醉恢复时间为 17.5±5.6min。 remimazolam 的 ED50 和 ED95 分别为 0.362mg/kg（95%可信区间：0.313-0.455mg/kg）和 0.464mg/kg（95%可信区间：0.403-2.242mg/kg）。所有患者的生命体征均在预定可接受范围内。无患者需要拮抗剂解救。
remimazolam 用于成人胃镜检查的 ED50 和 ED95 分别为 0.362mg/kg 和 0.464mg/kg，部分患者在胃镜检查时可能需要额外的麻醉药物。
ChiCTR2200057446。
