瑞马唑仑抑制老年病人双腔气管插管心血管反应的有效剂量

doi:10.3969/j.issn.1003-9198.2024.11.005

摘要/Abstract

摘要： 目的探讨复合舒芬太尼全麻期间瑞马唑仑抑制老年胸科非心脏手术病人双腔气管插管心血管反应的有效剂量。方法选取2022年10月至2023年4月全身麻醉下行双腔气管插管的老年胸科非心脏手术病人21例,采用序贯法进行试验,首例病人静推瑞马唑仑0.3 mg/kg,根据前一例病人气管插管心血管反应情况确定下一例病人瑞马唑仑剂量,若为阳性,则下一例病人剂量增加0.01 mg/kg;若为阴性,则下一例病人剂量减少0.01 mg/kg,当连续出现≥6个阳阴性交替的波形时,试验结束。采用Probit方法计算瑞马唑仑在老年胸科手术病人双腔气管插管反应中的半数有效剂量(ED50)和90%有效剂量(ED90)。结果 21例病人中,出现阳性反应10例,阴性反应11例。联合舒芬太尼抑制老年胸科手术病人双腔气管插管心血管反应的瑞马唑仑ED50为0.306 mg/kg,95%CI为0.291～0.328 mg/kg; ED90为0.322 mg/kg,95%CI为0.312～0.488 mg/kg。结论复合舒芬太尼抑制老年胸科手术病人双腔气管插管心血管反应的瑞马唑仑ED50为0.306 mg/kg,ED90为0.322 mg/kg。

关键词: 老年人, 瑞马唑仑, 双腔气管插管, 心血管反应, 量-效关系

Abstract: Objective To investigate the effective dose of remimazolam to inhibit the cardiovascular response to double-lumen endotracheal intubation during general anesthesia with sufentanil in the elderly patients who receiving thoracic non-cardiac surgery. Methods In this study, 21 elderly patients who underwent double-lumen tracheal intubation during thoracic non-cardiac surgery under general anesthesia were selected from October 2022 to April 2023, and the sequential method was used in this study. The first patient received intravenous injection of remimazolam 0.3 mg/kg, and the dose of remimazolam for the next patient was determined according to the cardiovascular response to tracheal intubation of the previous patient. If the cardiovascular response was positive, the dose was increased by 0.01 mg/kg; Instead, the dose of the next patient was decreased by 0.01 mg/kg, and the experiment was terminated when there were ≥6 consecutive alternating positive and negative waveforms. The Probit method was used to calculate the median effective dose (ED50) and the 90% effective dose (ED90) of remimazolam in inhibiting the cardiovascular response to double-lumen tracheal intubation. Results A total of 10 positive and 11 negative cases were observed in 21 patients. The ED50 of remimazolam combined with sufentanil in suppressing the cardiovascular response to double-lumen tracheal intubation during thoracic non-cardiac surgery in the elderly patients was 0.306 mg/kg, with a 95%CI of 0.291-0.328 mg/kg, and the ED90 was 0.322 mg/kg, with a 95%CI of 0.312-0.488 mg/kg. Conclusions The ED50 of remimazolam in inhibiting cardiovascular response to double-lumen endotracheal intubation was 0.306 mg/kg and the ED90 was 0.322 mg/kg in the elderly patients who underwent thoracic surgery under general anesthesia with sufentanil.

Key words: aged, remimazolam, double-lumen tracheal intubation, cardiovascular response, dose-effect relationship

中图分类号:

R 641

仲志刚, 陈静. 瑞马唑仑抑制老年病人双腔气管插管心血管反应的有效剂量[J]. 实用老年医学, 2024, 38(11): 1101-1104.

ZHONG Zhigang, CHEN Jing. Effective dose of remimazolam to inhibit cardiovascular response to double-lumen tracheal intubation in elderly patients[J]. Practical Geriatrics, 2024, 38(11): 1101-1104.

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