甲苯磺酸瑞马唑仑对接受腹膜透析置管术患者全身麻醉下气管插管反应的影响。
Effect of remimazolam tosylate on the response to endotracheal intubation under general anesthesia in patients undergoing catheter placement for peritoneal dialysis.
作者信息
Zong Jing, Yuan Peihua, Zhang Ruijiao, Wu Shiyin, Liu Mei, Qu Liangchao
机构信息
Department of Anesthesiology and Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University Nanchang 330001, Jiangxi, China.
Department of Anesthesiology, Ganjiang New Area People's Hospital Nanchang 330001, Jiangxi, China.
出版信息
Am J Transl Res. 2025 Feb 15;17(2):974-982. doi: 10.62347/XWSD5681. eCollection 2025.
OBJECTIVE
This study aims to observe the effects of remimazolam tosylate on the response to endotracheal intubation under general anesthesia in patients undergoing peritoneal dialysis catheter placement. Additionally, we seek to determine the 95% effective dose (ED95) of remimazolam tosylate for inhibiting the endotracheal intubation response in this patient population.
METHODS
This prospective study was registered with the China Clinical Trials Center (ChiCTR2200055709), https://www.chictr.org.cn/showproj.html?proj=149640. Patients scheduled for peritoneal dialysis catheter placement under general anesthesia at the First Affiliated Hospital of Nanchang University between January and June 2023 were selected. They were randomly assigned into the remimazolam tosylate group (R group) and the propofol group (P group), with 30 patients in each group. After anesthesia induction and subsequent endotracheal intubation, sedation efficacy and adverse reactions were recorded for both groups. Venous blood samples (1 mL) were collected from patients before anesthesia induction and after endotracheal intubation to measure levels of adrenaline and noradrenaline. The modified Dixon sequential method was used to determine the ED95 of remimazolam tosylate for inhibiting the endotracheal intubation response.
RESULTS
Levels of adrenaline and noradrenaline decreased significantly after endotracheal intubation in both the R group and P group, with no significant difference. Vital signs were more stable in the R group compared to the P group. Injection pain during anesthesia induction was reported in 3 patients (10%) in the R group, whereas 18 cases (60%) were observed in the P group. The Dixon sequential experiment included a total of 25 patients, with 13 (52%) showing positive responses and 12 (48%) negative responses.
CONCLUSIONS
Remimazolam tosylate is effective for inhibiting the systemic response to endotracheal intubation in patients undergoing peritoneal dialysis catheter placement. Additionally, the occurrence rate of hypotension and injection pain during anesthesia induction is significantly lower compared to propofol. The ED95 of remimazolam tosylate for inhibiting the endotracheal intubation response in peritoneal dialysis catheter placement patients is 0.332 mg/kg.
目的
本研究旨在观察甲苯磺酸瑞马唑仑对接受腹膜透析导管置入术患者全身麻醉下气管插管反应的影响。此外，我们试图确定甲苯磺酸瑞马唑仑在该患者群体中抑制气管插管反应的95%有效剂量（ED95）。
方法
本前瞻性研究已在中国临床试验中心（ChiCTR2200055709）注册，网址为https://www.chictr.org.cn/showproj.html?proj=149640。选取2023年1月至6月在南昌大学第一附属医院计划接受全身麻醉下腹膜透析导管置入术的患者。他们被随机分为甲苯磺酸瑞马唑仑组（R组）和丙泊酚组（P组），每组30例。麻醉诱导及随后气管插管后，记录两组的镇静效果和不良反应。在麻醉诱导前和气管插管后采集患者静脉血样本（1 mL），以测量肾上腺素和去甲肾上腺素水平。采用改良Dixon序贯法确定甲苯磺酸瑞马唑仑抑制气管插管反应的ED95。
结果
R组和P组气管插管后肾上腺素和去甲肾上腺素水平均显著下降，差异无统计学意义。与P组相比，R组生命体征更稳定。R组有3例患者（10%）在麻醉诱导期间出现注射痛，而P组观察到18例（60%）。Dixon序贯试验共纳入25例患者，其中13例（52%）为阳性反应，12例（48%）为阴性反应。
结论
甲苯磺酸瑞马唑仑可有效抑制接受腹膜透析导管置入术患者气管插管的全身反应。此外，与丙泊酚相比，麻醉诱导期间低血压和注射痛的发生率显著降低。甲苯磺酸瑞马唑仑在腹膜透析导管置入术患者中抑制气管插管反应的ED95为0.332 mg/kg。
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