瑞马唑仑复合舒芬太尼抑制单腔气管插管患者心血管反应的ED_(50)、ED_(95)  

ED 50 and ED 95 of Remimazolam Combined with Sufentanil for InhibitingCardiovascular Responses in Patients with Single-Lumen Endotracheal Intubation

作　　者：张晗[1] 毛珊珊 李萌 陈勇[1] ZHANG Han;MAO Shanshan;LI Meng;CHEN Yong(Department of Anesthesia and Perioperative Medicine,the First Affiliated Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]河南大学第一附属医院麻醉与围术期医学科,河南开封475000

出　　处：《河南医学研究》2024年第24期4510-4513,共4页Henan Medical Research

基　　金：开封市科技发展计划项目(2203025)。

摘　　要：目的 分析瑞马唑仑复合舒芬太尼抑制单腔气管插管患者心血管反应的半数有效剂量(ED_(50))、95%有效剂量(ED_(95))。方法 选取2022年5月至2023年5月在河南大学第一附属医院接受单腔气管插管的68例患者为研究对象,其中患者年龄为20~67岁,体重指数为18~26 kg·m~(-2),美国麻醉医师协会(ASA)分级为Ⅰ~Ⅱ级。按照改良Dixon序贯试验法,首例患者先静脉滴注舒芬太尼0.1μg·kg~(-1),于3 min后注射瑞马唑仑,初始剂量为0.2 mg·kg~(-1),等待患者意识消失,给予罗库溴铵0.6 mg·kg~(-1),行单腔气管插管,根据上1例患者心血管反应为阳性或者阴性,决定下1例患者瑞马唑仑剂量增加或降低1个剂量梯度,剂量梯度为0.01 mg·kg~(-1)。以Probit回归分析计算瑞马唑仑复合舒芬太尼抑制单腔气管插管患者心血管反应的ED_(50)、ED_(95),观察麻醉诱导前(T_1)、初次脑电双频指数(BIS)≤60时(T_2)、麻醉诱导后(T_3)不同时间点的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))变化。结果 瑞马唑仑复合舒芬太尼抑制单腔气管插管患者心血管反应的ED_(50)为0.180 mg·kg~(-1)(95%CI:0.154~0.196 mg·kg~(-1)),ED_(95)为0.195 mg·kg~(-1)(95%CI:0.165~0.204 mg·kg~(-1));不同时间点的MAP比较,差异无统计学意义(P>0.05);相较于T_1,T_2、T_3时的HR降低,SpO_(2)升高(P<0.05);给予患者瑞马唑仑后,出现1例恶心、1例头晕,苏醒后均恢复正常,未出现注射痛、低血压、心动过缓等情况。结论 瑞马唑仑复合舒芬太尼抑制单腔气管插管患者心血管反应的ED_(50)为0.180 mg·kg~(-1),ED_(95)为0.195 mg·kg~(-1)。Objective To analyze the median effective dose(ED 50)and 95%effective dose(ED 95)of remimazolam combined with sufentanil for inhibiting cardiovascular responses in patients with single-lumen endotracheal intubation.Methods A total of 68 patients who underwent single-lumen endotracheal intubation in the First Affiliated Hospital of Henan University from May 2022 to May 2023 were selected as the study subjects.The patients were 20-67 years old,with body mass index of 18-26 kg·m^(-2) and the American Society of Anesthesiologists(ASA)classification of classⅠ-Ⅱ.According to the modified Dixon’s sequential test method,the first patient was given intravenous infusion of sufentanil at 0.1μg·kg^(-1),and was injected with remimazolam 3 minues later,with an initial dose of 0.2 mg·kg^(-1). After the patient’s got into the loss of consciousness,the patient was treated with 0.6 mg·kg^(-1) of rocuronium and single-lumen endotracheal intubation.According to the situation of cardiovascular response in the previous patient,the next patient’s dose of remimazolam was increased or decreased by a dose gradient of 0.01 mg·kg^(-1).Probit regression analysis was performed to calculate the ED 50 and ED 95 of remimazolam combined with sufentanil for inhibiting cardiovascular responses in patients with single-lumen endotracheal intubation.The changes of heart rate(HR),mean arterial pressure(MAP)and oxyhemoglobin saturation(SpO 2)at different time points[before anesthesia induction(T 1),when the initial bispectral index(BIS)≤60(T 2)and after anesthesia induction(T 3)]were observed.Results The ED 50 and ED 95 of remimazolam combined with sufentanil for inhibiting cardiovascular responses in patients with single-lumen endotracheal intubation were 0.180 mg·kg^(-1)(95%CI:0.154-0.196 mg·kg^(-1))and 0.195 mg·kg^(-1)(95%CI:0.165-0.204 mg·kg^(-1)),respectively.There was no statistically difference in MAP at different time points(P>0.05).Compared to T 1,HR decreased and SpO_(2) increased at T 3 and T 4(P<0.05).After the administ

关 键 词：单腔气管插管 瑞马唑仑 舒芬太尼 心血管反应 半数有效剂量 95%有效剂量 

分 类 号：R614.2[医药卫生—麻醉学]