瑞马唑仑复合阿芬太尼抑制宫颈癌组织间插植术体动反应的半数有效剂量  

ED_(50) of remimazolam combined with alfentanil to inhibit body movement response during cervical cancer interstitial brachytherapy surgery

作　　者：姚静 赵晓春[2] 李松泽 唐禹 黄泽清 Yao Jing;Zhao Xiaochun;Li Songze;Tang Yu;Huang Zeqing(Department of Anesthesiology,Cancer Hospital of China Medical University,Liaoning Cancer Hospital&Institute,Shenyang 110042,China;Department of Anesthesiology,School and Hospital of Stomatology,China Medical University,Shenyang 110002,China;Department of Anesthesiology,Yingkou Central Hospital,Yingkou 115000,China)

机构地区：[1]中国医科大学肿瘤医院,辽宁省肿瘤医院麻醉科,辽宁沈阳110042 [2]中国医科大学附属口腔医院麻醉科,辽宁沈阳110002 [3]营口市中心医院麻醉科,辽宁营口115000

出　　处：《实用药物与临床》2024年第8期598-602,共5页Practical Pharmacy and Clinical Remedies

基　　金：省博士科研启动基金计划项目(2023-BS-044)。

摘　　要：目的探索瑞马唑仑复合阿芬太尼抑制宫颈癌组织间插植术体动反应的半数有效剂量(ED_(50))。方法选择辽宁省肿瘤医院2023年7月至10月宫颈癌组织间插植术患者25例,所有患者缓慢静注7μg/kg阿芬太尼,随后注射瑞马唑仑0.25 mg/kg,睫毛反射消失后进行宫颈癌组织间插植术。根据Dixon改良序贯法,若在插植过程中出现体动反应为阳性反应,下一位患者增加瑞马唑仑用量,否则为阴性反应,降低用量,剂量梯度0.01 mg/kg,直到出现7次折返,停止试验。记录入室时(T_(1))、给药完毕时(T_(2))、手术开始时(T_(3))、手术结束时(T_(4))患者心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))、脑电双频指数(BIS)水平变化及术中不良反应,采用Probit analysis概率单位回归分析计算瑞马唑仑的ED50及95%CI。结果纳入患者25例,阳性反应14例,阴性反应11例,患者术中生命体征平稳,2例一过性低血压,1例一过性心动过缓。复合阿芬太尼时,瑞马唑仑用于抑制宫颈癌组织间插植术体动反应的ED_(50)为0.28 mg/kg(95%CI:0.27~0.30 mg/kg)。结论瑞马唑仑复合阿芬太尼抑制宫颈癌组织间插植术体动反应的ED50为0.28 mg/kg(95%CI:0.27~0.30 mg/kg),患者呼吸循环稳定,镇静效果良好。Objective To explore the 50%effective dose(ED_(50))of remimazolam combined with alfentanil to inhibit body movement response during cervical cancer interstitial brachytherapy surgery.Methods Twenty-five patients who underwent cervical cancer interstitial brachytherapy surgery in Liaoning Cancer Hospital from July 2023 to October 2023 were enrolled.All patients were anesthetized with 7μg/kg alfentanil followed by 0.25 mg/kg remimazolam.The cervical cancer interstitial brachytherapy surgery was performed after the eyelash reflex disappeared.The dose of the next patient was set by the modified Dixon sequential method.If there was body movement response,the dose of next patient was increased;otherwise,the dose would be reduced.The dose gradient was 0.01 mg/kg until the seventh crossover point was observed,and the test was stopped.The heart rate(HR),mean artery pressure(MAP),oxygen saturation(SpO_(2))and bispectral index(BIS)at admission into the operating room(T_(1)),at the end of the administration(T_(2)),at the start of operation(T_(3))and at the end of operation(T_(4))were recorded.Adverse reactions were recorded.The ED_(50) and 95%confidence interval(CI)of remimazolam were calculated by Probit regression analysis.Results Totally 25 patients were included in the trail,14 patients had positive response,and 11 patients had negative response;the vital signs of the patients were stable during the operation,2 cases had a transient hypotension,and 1 case had a transient bradycardia.The ED_(50) of remimazolam combined with alfentanil to inhibit body movement response during cervical cancer interstitial brachytherapy surgery was 0.28 mg/kg(95%CI:0.27~0.30 mg/kg).Conclusion The ED50 of remimazolam combined with alfentanil to inhibit body movement response during cervical cancer interstitial brachytherapy surgery is 0.28 mg/kg(95%CI:0.27~0.30 mg/kg).It provides adequate sedation with stable respiratory circulation.

关 键 词：瑞马唑仑 阿芬太尼 宫颈癌组织间插植术 半数有效剂量 

分 类 号：R614[医药卫生—麻醉学] R737.33[医药卫生—外科学]