瑞马唑仑对老年患者气管插管时依托咪酯半数有效血浆浓度的影响  

Effect of Remimazolam on the Median Effective Plasma Concentration of Etomidate During Tracheal Intubation in Elderly Patients

作　　者：黄景贤[1] 黄华庚[1] 秦东全 冉雪莲[1] 黄浩松 黄群英[1] HUANG Jingxian;HUANG Huageng;QIN Dongquan;RAN Xuelian;HUANG Haosong;HUANG Qunying(The Second People's Hospital of Nanning,Nanning,Guangxi,China 530031)

机构地区：[1]广西壮族自治区南宁市第二人民医院,广西南宁530031

出　　处：《中国药业》2023年第17期104-107,共4页China Pharmaceuticals

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题[Z20200568]。

摘　　要：目的探讨瑞马唑仑对老年患者气管插管时依托咪酯半数有效血浆浓度(Cp_(50))的影响。方法选取医院2021年8月至2022年1月收治的行单腔导管气管插管全身麻醉手术的老年患者60例,随机分为对照组和观察组,各30例,按剔除标准最终分别纳入24例、26例。对照组患者静脉缓慢推注舒芬太尼和依托咪酯麻醉诱导,观察组患者在此基础上预先静脉注射0.1 mg/kg甲苯磺酸瑞马唑仑。两组患者均遵循Dixon改良序贯法原则设定依托咪酯的血浆靶浓度,依据预试验,首例患者依托咪酯血浆靶浓度对照组设为0.99μg/mL,观察组设为0.58μg/mL;视气管插管反应,阳性则上调下一例患者的依托咪酯血浆靶浓度,阴性则下调。采用Probit回归分析计算两组的依托咪酯Cp_(50)及95%置信区间(95%CI);观察两组患者的依托咪酯用量、麻醉诱导期间去甲肾上腺素用量、气管导管拔除时间,以及不良反应发生情况。结果观察组依托咪酯Cp_(50)为0.62μg/mL[95%CI(0.54,0.70)],显著低于对照组的0.97μg/mL[95%CI(0.88,1.06)]。观察组患者依托咪酯给药量为(0.32±0.07)mg/kg,显著低于对照组的(0.46±0.08)mg/kg(P<0.05);麻醉诱导期间,两组患者的去甲肾上腺素用量及气管导管拔除时间比较,差异无统计学意义(P>0.05);观察组患者肌阵挛发生率为7.69%,显著低于对照组的37.50%(P<0.05)。结论0.1 mg/kg瑞马唑仑可降低老年患者气管插管时依托咪酯的Cp_(50),对拔除气管导管时间无影响,且安全性良好。Objective To investigate the effect of remimazolam on the median effective plasma concentration(Cp_(50))of etomidate during tracheal intubation in elderly patients.Methods A total of 60 elderly patients who underwent general anesthesia with elective single-lumen catheter tracheal intubation in the hospital were selected and randomly divided into the control group and the observation group,with 30 cases in each group.According to the exclusion criteria,24 cases and 26 cases were included in the control group and the observation group,respectively.The patients in the control group received slow intravenous infusion of sufentanil and etomidate for anesthesia induction,and on this basis,the patients in the observation group were pre-injected with 0.1 mg/kg of remimazolam toluenesulfonate.The plasma target concentration of etomidate was set according to the principle of the Dixon modified sequential method,and the plasma target concentration of etomidate of the first patient was set at 0.99µg/mL in the control group and 0.58µg/mL in the observation group according to the pre-test.According to the endotracheal intubation response,positive cases upregulated while the negative cases downregulated the plasma target concentration of etomidate in the next case,with an adjacent ratio of 1∶1.2.The Cp_(50) and 95%confidence interval(CI)of etomidate in the two groups were calculated by the Probit regression analysis.The dose of etomidate and norepinephrine during anesthesia induction,the time of tracheal extubation,and the incidence of adverse reactions were observed.Results The Cp_(50) of etomidate in the observation group was 0.62µg/mL[95%CI(0.54,0.70)],which was significantly lower than 0.97µg/mL[95%CI(0.88,1.06)]in the control group.The dose of etomidate in the observation group was(0.32±0.07)mg/kg,which was significantly lower than(0.46±0.08)mg/kg in the control group(P<0.05).The difference in the dose of norepinephrine and the time of tracheal extubation between the two groups during the induction of anesthesia wa

关 键 词：瑞马唑仑 依托咪酯 半数有效血浆浓度 气管插管 

分 类 号：R969.4[医药卫生—药理学] R971.2[医药卫生—药学]