瑞马唑仑预防全麻诱导期丙泊酚注射痛在日间宫腔镜手术患者中的有效剂量测定  

Determination of effective dose of remimazolam for propofol injection pain prevention during general anesthesia induction in patients undergoing daytime hysteroscopic surgery

作　　者：陈红芽 王惠军[1] 奚春花[1] 吴黎黎[1] 胡春华 杜英杰 王珊珊[1] 王古岩 Chen Hongya;Wang Huijun;Xi Chunhua;Wu Lili;Hu Chunhua;Du Yingjie;Wang Shanshan;Wang Guyan(Department of Anesthesiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院麻醉科,100730

出　　处：《北京医学》2025年第2期112-115,共4页Beijing Medical Journal

基　　金：北京市医院管理中心“登峰”人才培养计划(DFL20220203)。

摘　　要：目的探讨瑞马唑仑预防日间宫腔镜手术患者全麻诱导期丙泊酚注射痛的半数有效剂量(50%effective dose,ED_(50))和95%有效剂量(95%effective dose,ED_(95))。方法选取2024年1—3月首都医科大学附属北京同仁医院接受择期喉罩全麻行日间宫腔镜手术患者22例,麻醉诱导期予瑞马唑仑预处理,依次给予丙泊酚、瑞芬太尼、米库氯铵行全麻诱导。采用改良Dixon序贯法进行研究,瑞马唑仑起始剂量为0.08 mg/kg,若患者丙泊酚注射痛为阴性,则下一例患者减少剂量,反之,则增加剂量;瑞马唑仑剂量增减梯度为0.01 mg/kg,直到出现7次阴性-阳性反应折返点后停止试验。同时观察麻醉期间不良反应发生情况。结果22例患者均为女性,年龄25~65岁,平均(47.0±11.4)岁。瑞马唑仑用于日间宫腔镜手术患者预防麻醉诱导期丙泊酚注射痛的ED_(50)为0.060 mg/kg(95%CI:0.052~0.067 mg/kg),ED_(95)为0.072 mg/kg(95%CI:0.066~0.108 mg/kg)。麻醉诱导期共发生低血压6例、恶心呕吐1例、头晕1例,未见其他不良反应。结论瑞马唑仑预防日间宫腔镜手术患者全麻诱导期丙泊酚注射痛的ED_(50)为0.060 mg/kg(95%CI:0.052~0.067 mg/kg),ED_(95)为0.072 mg/kg(95%CI:0.066~0.108 mg/kg),且无严重不良反应发生。Objective To explore the 50%effective dose(ED_(50))and 95%effective dose(ED_(95))of remimazolam for propofol injection pain prevention in patients undergoing daytime hysteroscopic surgery.Methods A total of 22 patients who underwent daytime hysteroscopy under general anesthesia with laryngeal mask airway in Beijing Tongren Hospital,Capital Medical University from January 2024 to March 2024 were selected.During the induction period of anesthesia,remimazolam was pretreated,propofol sedated,remifentanil analgesia,and neuromuscular block with mivacurium chloride.The modified Dixon sequential method was used for the study.The initial dose of remimazolam was 0.08 mg/kg.If the pain of propofol injection was negative,the dose of the next patient was reduced.Otherwise,the dose was increased.The dose gradient of remimazolam was 0.01 mg/kg,and the experiment was stopped after seven negative-positive returning-points.The occurrence of adverse reactions during anesthesia was also observed.Results All the 22 patients were female,aged from 25 to 65 years,with an average of(47.0±11.4)years.The ED_(50)and ED_(95)of remimazolam used for propofol injection pain prevention in patients with daytime hysteroscopic surgery were 0.060 mg/kg(95%CI:0.052-0.067 mg/kg)and 0.072 mg/kg(95%CI:0.066-0.108 mg/kg)respectively.There were six cases of hypotension,one case of nausea and vomiting,one case of dizziness,and no other adverse reactions.Conclusions In patients undergoing daytime hysteroscopic surgery,the ED_(50)and ED_(95)of remimazolam for propofol injection pain prevention are 0.060 mg/kg(95%CI:0.052-0.067 mg/kg)and 0.072 mg/kg(95%CI:0.066-0.108 mg/kg),and no serious adverse reactions occurs.

关 键 词：全身麻醉 瑞马唑仑 丙泊酚 注射痛 宫腔镜诊疗 

分 类 号：R614[医药卫生—麻醉学]