序贯试验法测定苯磺酸瑞马唑仑联合阿芬太尼在老年患者无痛支气管镜检查ED50与ED95  

ED50 and ED95 of Remiazolam Benzenesulfonic Acid Combined with Alfentanil in Sequential Test of Painless Bronchoscopy of Elderly Patients

作　　者：韩略平 武复召 贾雅蕊[2] 王冬雨 宋强 宋海龙 SONG Haiong;HAN Luoping;WU Recall;JIA Yarui;WANG Dongyu;SONG Qiang;SONG Hailong(Anesthesia Surgery Department,Anesthesia and Pain Diagnosis and Treatment Center,Caoxian County People's Hospital,Heze,Shandong 274400;Anesthesia Department,Heze City Hospital,Heze,Shandong 274031)

机构地区：[1]曹县人民医院麻醉手术部、麻醉与疼痛诊疗中心,山东菏泽274400 [2]菏泽市立医院麻醉科,山东菏泽274031

出　　处：《智慧健康》2023年第22期182-186,共5页Smart Healthcare

基　　金：山东省医学会镇痛镇静优化专项资金[YXH2021ZX033,YXH2022ZX05265];中国红十字基金会医学赋能公益专项基金[CRCF-YXFN-202201060]。

摘　　要：目的研究阿芬太尼复合瑞马唑仑在老年患者无痛支气管镜检查的半数有效剂量(ED50)和95%有效剂量(ED95)。方法选择2022年1—11月在曹县人民医院60例拟行无痛支气管镜检查的老年患者,随机分为A组(n=30例,阿芬太尼剂量为5μg/kg)和B组(n=30例,阿芬太尼剂量为10μg/kg)。所有患者麻醉诱导静脉注射阿芬太尼,随后瑞马唑仑采用序贯试验法,首位患者给予剂量为0.16mg/kg,根据患者反映情况调整瑞马唑仑使用剂量梯度,分析瑞马唑仑在支气管镜检查患者可进镜检查的ED50和ED95。结果A组患者瑞马唑仑ED50为0.154 mg/kg(95%CI 0.146~0.162mg/kg),ED95为0.195mg/kg(95%CI 0.174~0.320mg/kg);B组患者瑞马唑仑ED50为0.126mg/kg(95%CI0.098~0.151mg/kg),ED95为0.150mg/kg(95%CI0.135~0.420mg/kg)。结论5μg/kg阿芬太尼复合瑞马唑仑在老年支气管镜检查患者可进镜检查的ED50为0.154mg/kg,10μg/kg阿芬太尼复合瑞马唑仑支气管镜可进镜检查有效剂量ED50为0.126mg/kg,且提高麻醉诱导剂阿芬太尼的剂量可降低瑞马唑仑的有效剂量ED50,且低剂量瑞马唑仑对呼吸抑制较轻,血压较平稳,副作用较少,插管反应更轻微。Objective To study half effective dose(ED50)and 95%effective dose(ED95)of alfentanil combined with remiazolam for elderly patients with painless bronchoscopy.Methods The paper chose 60 elderly patients with painless bronchoscopy in Caoxian County People's Hospital from January 2022 to November 2022,and divided them into group A(n=30 cases,dose of alfentanil was 5μg/kg),group B(n=30 cases,with dose of alfentanil 10μg/kg)randomly.All patients were anesthetized with alfentanil intravenous injection,and remiazolam with sequential test method,with dose of 0.16 mg/kg for the first patient.Dose gradient of remiazolam was adjusted according to response of patient.ED50 and ED95 of remiazolam that could be examined by bronchoscopy were analyzed.Results ED50 of remazolam in group A was 0.154 mg/kg(95%CI 0.146~0.162mg/kg),and ED95 was 0.195mg/kg(95%CI 0.174~0.320mg/kg).ED50 of group B was 0.126 mg/kg(95%CI 0.098~0.151mg/kg)and ED95 was 0.150 mg/kg(95%CI 0.135~0.420mg/kg).Conclusion ED50 of 5μg/kg alfentanil combined with remiazolam for elderly patients with bronchoscopy was 0.154 mg/kg,ED50 of 10μg/kg alfentanil combined with remiazolam bronchoscopy was 0.126mg/kg,and increasing anesthesia inducer alfentanil could reduce effective dose ED50 of remiazolam.In addition,low-dose remiazolam had less respiratory inhibition,stable blood pressure,fewer side effect,and less intubation reaction.

关 键 词：阿芬太尼 瑞马唑仑 支气管镜 老年患者 半数有效量 

分 类 号：R614[医药卫生—麻醉学]