腕踝针对瑞马唑仑用于不同性别年龄无痛胃镜检查术患者意识消失药效学的影响  

Effect of wrist-ankle acupuncture on pharmacodynamics of remimazolam for loss of consciousness in patients of different genders and ages undergoing painless gastroscopy

作　　者：孔丽丽 周娜 侯佳楠 原静 王钦娴 李彦丽 李艳红 郝巍 Kong Lili;Zhou Na;Hou Jianan;Yuan Jing;Wang Qinxian;Li Yanli;Li Yanhong;Hao Wei(Department of Anesthesiology,The First Affiliated Hospital of Hebei University of Chinese Medicine Key Laboratory of Integrated Chinese and Western Medicine for Gastroenterology Research(Hebei),Hebei Technology Innovation Center of TCM Spleen and Kidney Diseases,Shijiazhuang 050011,China)

机构地区：[1]河北中医学院第一附属医院麻醉科河北省中西医结合胃肠病研究重点实验室,石家庄050011

出　　处：《中华麻醉学杂志》2023年第12期1507-1509,共3页Chinese Journal of Anesthesiology

基　　金：河北省中医药管理局项目(2021013)。

摘　　要：目的评价腕踝针对瑞马唑仑用于不同性别年龄无痛胃镜检查术患者意识消失药效学的影响。方法拟行无痛胃镜检查术患者,ASA分级Ⅰ或Ⅱ级,按性别、年龄分为4组:老年男性(年龄≥65岁)组(AM组)、老年女性(年龄≥65岁)组(AF组)、年轻男性(18岁≤年龄<65岁)组(YM组)和年轻女性(18岁≤年龄<65岁)组(YF组)。腕踝针针刺患者双上肢1、2区10 min后采用改良Dixon序贯法进行试验,静脉注射瑞马唑仑起始剂量为0.20 mg/kg,意识消失,下一例患者降低1个剂量梯度,否则升高1个剂量梯度,剂量梯度为0.05 mg/kg,意识消失的标准:MOAA/S评分0或1分,重复此过程直至出现7个转折。采用probit法计算瑞马唑仑的半数有效剂量(ED_(50))及其95%置信区间(CI)。结果AM组、AF组、YM组和YF组ED_(50)及其95%CI依次为0.296(0.233~0.376)、0.319(0.262~0.388)、0.323(0.278~0.375)和0.344(0.285~0.415)mg/kg。4组ED_(50)比较差异无统计学意义(P>0.05)。结论在腕踝针作用下瑞马唑仑用于不同性别年龄无痛胃镜检查术患者意识消失的药效学相似。Objective To evaluate the effect of wrist-ankle acupuncture on the pharmacodynamics of remimazolam for loss of consciousness in the patients of different genders and ages undergoing painless gastroscopy.Methods American Society of Anesthesiologists Physical Status classificationⅠorⅡpatients,undergoing elective painless gastroscopy,were divided into 4 groups according to gender and age:agedmale(age≥65 yr)group(group AM),agedfemale(age≥65 yr)group(group AF),young male(18 yr≤age<65 yr)group(group YM),and young female(18 yr≤age<65 yr)group(group YF).After 10 min of wrist-ankle acupuncture on 1st and 2nd areas of the bilateralupper limbs of the patient,modified Dixon′s up-and-down sequential experiment was used for the test.The initial dose of intravenous remimazolam was 0.20 mg/kg.Each time the dose increased/decreased by 0.05 mg/kg.If the patient lost consciousness,the next patient received a lower dose of remimazolam,otherwise a higher dose was given in the next patient.Loss of consciousness was defined as MOAA/S score was 0 or 1,and the process was repeated until 7 turning points appeared.The median effective dose(ED_(50))and 95%confidence interval of remimazolam were calculated by probit method.Results The ED_(50) and 95%confidence interval of remimazolam were 0.296(0.233-0.376),0.319(0.262-0.388),0.323(0.278-0.375)and 0.344(0.285-0.415)mg/kg in AM,AF,YM and YF groups,respectively.There was no significant difference in ED_(50) among the four groups(P>0.05).Conclusions Under the action of wrist-ankle acupuncture,the pharmacodynamics of remazolam is comparable when used for the patients of different genders and ages undergoing painless gastroscopy.

关 键 词：腕踝针疗法 苯二氮类 胃镜检查 剂量效应关系 药物 

分 类 号：R969[医药卫生—药理学]