不同剂量右美托咪定对瑞马唑仑致患者意识消失ED95及应激反应的影响  

Effect of different doses of dexmedetomidine on the loss of consciousness ED95 and stress response in patients caused by remimazolam

作　　者：张芮 王志涛[1] 刘德君[1] 马恒 ZHANG Rui;WANG Zhitao;LIU Dejun;MA Heng(Department of Anesthesiology and Perioperative Medicine,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450001,China)

机构地区：[1]郑州大学第二附属医院麻醉与围术期医学部,郑州450001

出　　处：《实用医学杂志》2023年第4期476-480,共5页The Journal of Practical Medicine

基　　金：白求恩·围术期镇痛镇静研究(编号:BCF-RFWSQZTZJ-202011-036)。

摘　　要：目的 探讨不同剂量右美托咪定对瑞马唑仑致患者意识消失ED95及全麻诱导期间气管插管应激反应的影响。方法 选择气管插管全麻患者87例,随机分为瑞马唑仑组(R组)、0.5μg/kg右美托咪定复合瑞马唑仑组(RD1组)和1.0μg/kg右美托咪定复合瑞马唑仑组(RD2组)。3组分别输注生理盐水、右美托咪定0.5μg/kg和1.0μg/kg,其后按序贯法泵注瑞马唑仑,计算瑞马唑仑致患者意识消失ED95及95%CI。结果R组、RD1组和RD2组瑞马唑仑ED95及95%CI分别为0.250(0.234~0.397)、0.199(0.190~0.258)和0.184(0.172~0.282)mg/kg。结论 预注右美托咪定0.5μg/kg和1.0μg/kg均可降低瑞马唑仑致患者意识消失的ED95,减轻插管应激反应。但应用右美托咪定1.0μg/kg有导致心率减慢的风险。Objective To investigate the effects of different doses of dexmedetomidine on the loss of consciousness ED95 caused by remimazolam and the stress response to tracheal intubation during induction of general anesthesia.Methods Eighty-seven patients under general anesthesia with tracheal intubation were selected and randomly assigned to the remimazolam group(group R),0.5 μg/kg dexmedetomidine combined with remimazolam group(group RD1)and 1.0 μg/kg dexmedetomidine combined with remimazolam group(group RD2).The three groups were infused with saline,dexmedetomidine 0.5 μg/kg and 1.0 μg/kg,respectively,followed by the sequential pumping of remimazolam.The ED95 and 95% CI for loss of consciousness due to remimazolam were calculated.Results The ED95 and 95% CI for remimazolam were 0.250(0.234 ~ 0.397),0.199(0.190 ~ 0.258),and 0.184(0.172 ~ 0.282)mg/kg in three groups respectively.Conclusion Preinfusion of dexmedetomidine 0.5 μg/kg and1.0 μg/kg both reduced the ED95 of rimazolam-induced loss of consciousness in patients and attenuated intubation stress.However,application of dexmedetomidine 1.0 μg/kg had the risk of causing heart rate slowing.

关 键 词：瑞马唑仑 右美托咪定 量效关系 应激 

分 类 号：R614.2[医药卫生—麻醉学]