[罂粟摘要]瑞马唑仑用于老年患者麻醉诱导的中位有效剂量和脑电双频指数：上下顺序分配试验

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瑞马唑仑用于老年患者麻醉诱导的中位有效剂量和脑电双频指数：上下顺序分配试验

贵州医科大学 麻醉与心脏电生理课题

翻译: 严旭

编辑: 严旭

审校: 曹莹

目的：

瑞马唑仑是一种新型超短苯二氮卓类药物，适用于60岁以上的老年患者全身麻醉诱导，但其最佳剂量不清楚。因此，这项研究旨在确定瑞马唑仑诱导的有效剂量，并探索其与脑电双频指数（BIS）的相关性。

患者和方法：

共有42名老年患者分为两组：60-69岁（A组）和70-85岁（B组）。初始剂量为0.1mg/kg（A组）和0.05 mg/kg（B组）瑞马唑仑，并使用修改后的观察者警觉性评估/镇静量表来评估适当的反应。剂量使用是基于之前反应的上下分配技术计算的。使用顺序公式和probit回归模型来计算ED50和BIS50。ED95是使用probit回归模型确定的。

结果：

在A组和B组中，用于麻醉诱导瑞马唑仑的ED50分别为0.088mg/kg（95%置信区间[CI] 0.071-0.108）和0.061mg/kg（95%CI 0.053-0.069）。A组和B组的ED95分别为0.118mg/kg（95%CI 0.103-0.649）和0.090mg/kg（95%CI 0.075-0.199）。瑞马唑仑可能会减少BIS。A组和B组的BIS50分别为86.0（95%CI 83.7-88.6）和85.4（95%CI 84.1-86.8）。

结论：

在诱导过程中应观察患者的意识。在仔细考虑个体变化后，来选择瑞马唑仑的剂量。

原始文献来源：

Miao Liu , Yuan Sun, Lingxue Zhou,The Median Effective Dose and Bispectral Index of Remimazolam Tosilate for Anesthesia Induction in Elderly Patients: An Up-and-DownSequentialAllocationTrial.Dovepress,Clinical Interventions in Aging 2022:17 837–843

英文原文：

The Median Effective Dose and Bispectral Index of Remimazolam Tosilate for Anesthesia Induction in Elderly Patients: An Up-and-Down Sequential Allocation Trial

Abstract

Purpose: Remimazolam is a new type of ultrashort benzodiazepine drug with an unclear optimal dose for general anesthesia induction in elderly patients aged >60 years. Therefore, this study aimed to determine the effective dose of remimazolam tosilate induction and explore its correlation with the bispectral index (BIS).

Patients and methods: A total of 42 elderly patients were divided into two age groups: 60-69 (group A) and 70-85 (group B) years. An initial dose of 0.1mg/kg(Group A) and 0.05 mg/kg(Group B) remimazolam tosilate was administered, and the Modified Observer's Assessment of Alertness/Sedation scale was used to assess adequate responses. The dose was calculated using the up-and-down allocation technique based on the previous response. The sequential formula and probit regression model were used to calculate ED50 and BIS50. ED95 was determined using the probit regression model.

Results: The ED50 of remimazolam tosilate for anesthesia induction were 0.088 mg/kg (95% confidence interval [CI] 0.071-0.108) and 0.061 mg/kg (95% CI 0.053-0.069) in groups A and B, respectively. ED95 was 0.118 mg/kg (95% CI 0.103-0.649) and 0.090 mg/kg (95% CI 0.075-0.199) in groups A and B, respectively. The remimazolam tosilate administration could decrease BIS. BIS50 was 86.0 (95% CI 83.7-88.6) and 85.4 (95% CI 84.1-86.8) in groups A and B, respectively.

Conclusion: During the induction process, patients' consciousness should be observed. The dose of remimazolam tosilate could be chosen after careful consideration of individual variations.

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