年龄因素对瑞马唑仑镇静效力的影响  

Effect of age on sedative potency of remimazolam

作　　者：黄瑾 张珈硕 马凤丹 姜卜维 王晟昱 韩亚楠 王春光[1] Huang Jin;Zhang Jiashuo;Ma Fengdan;Jiang Bowei;Wang Shengyu;Han Yanan;Wang Chunguang(Department of Anesthesiology,Baoding First Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院麻醉科,保定071000

出　　处：《中华麻醉学杂志》2024年第9期1127-1130,共4页Chinese Journal of Anesthesiology

摘　　要：目的:评价年龄因素对瑞马唑仑镇静效力的影响。方法:本研究为前瞻性研究。选取保定市第一中心医院2023年9月1日至11月1日择期在全身麻醉下进行手术的患者,性别不限,年龄40~80岁,BMI 18~28 kg/m^(2),ASA分级Ⅰ或Ⅱ级,根据患者年龄,分为中年组(40~64岁)和老年组(65~80岁)。采用Dixon序贯法进行试验,瑞马唑仑初始剂量为0.3 mg/kg,给药后3 min内改良警觉/镇静评分≤1分且BIS值≤60判定为镇静有效。瑞马唑仑剂量根据上一例患者镇静有效或无效而减少或增加,剂量梯度为0.03 mg/kg。采用probit法计算瑞马唑仑的半数有效剂量(ED_(50))及其95%可信区间(CI)。记录患者意识消失时间。结果:中年组瑞马唑仑ED_(50)(95%CI)为0.345(0.306~0.384)mg/kg,老年组瑞马唑仑ED_(50)(95%CI)为0.322(0.303~0.339)mg/kg,中年组ED_(50)高于老年组(u=417.00,P=0.022)。老年组意识消失时间长于中年组(t=-2.96,P=0.008)。结论:对于40~80岁的中老年患者,随年龄增加,瑞马唑仑的镇静效力增强。ObjectiveTo evaluate the effect of age on the sedative potency of remimazolam.MethodsThis was a prospective study.Patients of either sex,aged 40-80 yr,with body mass index of 18-28 kg/m^(2),of American Society of Anesthesiologists Physical Status classificationⅠorⅡ,scheduled for elective surgery with general anesthesia,were divided into middle age group(40-64 yr)and elderly group(65-80 yr)based on the age of the patients.The test was performed by the Dixon′s up-and-down method.The initial dose of remimazolam was 0.3 mg/kg.The Modified Observer′s Assessment of Alertness/Sedation Scale score≤1 and bispectral index value≤60 within 3 min after administration were considered as an effective sedation.The dose of remimazolam was increased/decreased by 0.03 mg/kg based on the sedative efficacy in the previous patient.The 50%effective dose(ED_(50))and 95%confidence interval(CI)of remimazolam were calculated by the probit method.The time to the loss of consciousness was recorded.ResultsThe ED_(50)(95%CI)of remimazolam was 0.345(0.306-0.384)mg/kg in middle age group,while the ED_(50)(95%CI)of remimazolam was 0.322(0.303-0.339)mg/kg in elderly group.The ED_(50) was significantly higher in middle age group than in elderly group(u=417.00,P=0.022).The time to loss of consciousness was significantly longer in elderly group than in middle age group(t=-2.96,P=0.008).ConclusionsFor middle-aged and elderly patients aged 40-80 yr,the sedative potency of remimazolam increases with age.

关 键 词：年龄因素 瑞马唑仑 清醒镇静 剂量效应关系 药物 

分 类 号：R614[医药卫生—麻醉学]