摘要
目的:探讨瑞马唑仑用于择期全麻气管插管患者诱导期的有效剂量,并在SEDLine监测下评估其对患者状态指数(PSI)的影响。方法:纳入择期全麻手术患者49例,按年龄分为A组(18~64岁)和B组(65~85岁)。采用Dixon序贯法进行试验,瑞马唑仑初始剂量为A组0.3 mg·kg^(-1),B组0.2 mg·kg^(-1),相邻剂量相差0.05 mg·kg^(-1)。采用改良警觉/镇静评分(MOAA/S评分)评估镇静深度。记录患者清醒安静时、给药后2 min和加药后2 min的PSI、平均动脉压(MAP)和心率。结果:A组和B组瑞马唑仑全麻诱导的ED_(50)分别为0.167 mg·kg^(-1)(95%CI:0.047~0.244 mg·kg^(-1))和0.157 mg·kg^(-1)(95%CI:0.099~0.205 mg·kg^(-1));ED_(95)分别为0.310 mg·kg^(-1)(95%CI:0.238~1.199 mg·kg^(-1))和0.252 mg·kg^(-1)(95%CI:0.204~0.616 mg·kg^(-1))。瑞马唑仑给药后可降低PSI和MAP。结论:瑞马唑仑可安全有效地用于择期全麻患者的诱导,诱导期间血流动力学相对平稳。PSI能客观、连续地反映瑞马唑仑的镇静深度,可作为指导个体化精准给药的可靠监测指标。
Objective:To investigate the effective dose of remimazolam for the induction phase in patients undergoing selective general anesthesia with tracheal intubation,and to evaluate its effects on patient state index(PSI)under SEDLine monitoring.Methods:Forty-nine patients were allocated into two groups based on age:Group A(18-64 years)and Group B(65-85 years).The Dixon's up-and-down sequential method was employed.The initial dose of remimazolam was set at 0.3 mg·kg^(-1)for Group A and 0.2 mg·kg^(-1)for Group B,with a dose interval of 0.05 mg·kg^(-1).Sedation level was assessed using the Modified Observer's Assessment of Alertness/Sedation(MOAA/S)scale.PSI,mean arterial pressure(MAP),and heart rate(HR)were recorded at baseline(awake and calm),2 minutes after initial drug administration,and 2 minutes after supplemental dosing.Results:The ED_(50)of remimazolam for general anesthesia induction was 0.167 mg·kg^(-1)(95%CI:0.047-0.244)in Group A and 0.157 mg·kg^(-1)(95%CI:0.099-0.205)in Group B.The ED_(95)values were 0.310 mg·kg^(-1)(95%CI:0.238-1.199)and 0.252 mg·kg^(-1)(95%CI:0.204-0.616),respectively.Administration of remimazolam significantly reduced PSI and MAP.Conclusion:Remimazolam can be safely and effectively used for induction in patients undergoing selective general anesthesia,providing relatively stable hemodynamics during the induction period.
作者
佟星
孙蓓
吴浩
陈利海
韩流
TONG Xing;SUN Bei;WU Hao;CHEN Lihai;HAN Liu(Department of Anesthesiology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China;Department of Anesthesiology,Nanjing Hospital of Chinese Medicine,Nanjing 210022,China;Department of Anesthesiology,Nanjing Drum Tower Hospital,Nanjing 210008,China)
出处
《药学与临床研究》
2026年第1期23-26,共4页
Pharmaceutical and Clinical Research
基金
南京市卫生科技发展专项资金项目计划(YKK21128)
中国红十字基金会医学赋能公益专项基金(CRCFYXFN-202302144)。
