| 沈卓尔,徐海,朱婷婷,等.复合阿芬太尼时瑞马唑仑在不同性别老年病人中抑制胃镜置入反应的半数有效剂量[J].安徽医药,2026,30(4):834-838. |
| 复合阿芬太尼时瑞马唑仑在不同性别老年病人中抑制胃镜置入反应的半数有效剂量 |
| Median effective dose of remimazolam for suppressing gastroscope insertion response in elderly male and female patients when combined with alfentanil |
| |
| DOI：10.3969/j.issn.1009-6469.2026.04.039 |
| 中文关键词: 瑞马唑仑 麻醉，静脉 阿芬太尼 苯二氮.类 胃镜检查 半数有效剂量 老年人 |
| 英文关键词: Remimazolam Anesthesia,intravenous Alfentanil Benzodiazepines Gastroscopy Median effective dose Aged |
| 基金项目: |
|
| 摘要点击次数: 197 |
| 全文下载次数: 124 |
| 中文摘要: |
| 目的探讨在不同性别的老年病人中，复合阿芬太尼时瑞马唑仑抑制胃镜置入反应的半数有效剂量。方法采用前瞻性研究方法，纳入 2022年 5月至 2023年 2月嘉兴市第二医院内镜中心拟行无痛胃镜检查的老年病人 64例［年龄范围 65~80岁，身体质量指数(BMI)范围 18~28 kg/m2，美国麻醉医师协会(ASA)Ⅰ~Ⅱ，按性别分为男性组(n=30)和女性组( n=34)］。病人检查前禁食 8h、禁饮 2h，建立上肢静脉通路，通过鼻导管吸氧( 3~5 L/min)连续监测心率、血氧饱和度( SpO.)、呼吸频率( RR)及间断血压。病人静脉缓慢注射阿芬太尼 6 μg/kg，30 s后按改良 Dixon序贯法，静脉注射瑞马唑仑(首例剂量 0.17 mg/kg)，根据胃镜置入反应(咳嗽或体动)调整后续病人剂量，观察 9个阳性 -阴性交叉点后停止研究。半数有效剂量( ED50)及 95%有效剂量(ED95)采用 Probit法计算。结果所有病人顺利完成检查，未发生严重不良事件。两组病人在年龄、 BMI、ASA分级、术前心率 和平均动脉压( MAP)及检查时间方面差异无统计学意义( P>0.05)。男性组瑞马唑仑抑制胃镜置入反应的 ED50为 0.17 mg/kg， ED95为 0.21 mg/kg；女性组 ED50为 0.14 mg/kg，ED95为 0.18 mg/kg。结论复合阿芬太尼 6 μg/kg时，男性病人组瑞马唑仑抑制胃镜置入反应的 ED50为 0.17 mg/kg；女性病人组瑞马唑仑抑制胃镜置入反应的 ED50为 0.14 mg/kg，两者等效比值为 1.21。 |
| 英文摘要: |
| Objective To investigate the median effective dose (ED50) of remimazolam required to suppress gastroscope insertion re-sponse in elderly patients of any sex under combined alfentanil administration.Methods This prospective study enrolled 64 elderly patients (aged 65-80 years, BMI 18-28 kg/m2, ASA Ⅰ-Ⅱ) at the Endoscopy Center of The Second Hospital of Jiaxing from May 2022 toFebruary 2023 scheduled for painless gastroscopy. Patients were divided by sex into a male group (n=30) and a female group (n=34).Prior to the procedure, patients fasted for 8 hours and abstained from drinking for 2 hours. A peripheral intravenous line was estab-lished, and oxygen was delivered via nasal cannula at 3-5 L/min. Heart rate (HR), peripheral capillary oxygen saturation (SpO.), respira-tory rate (RR), and intermittent blood pressure (BP) were continuously monitored. Patients received slow intravenous alfentanil 6 μg/kg,followed 30 seconds later by remimazolam administered intravenously according to a modified Dixon sequential method (initial dose 0.17 mg/kg). Subsequent doses were adjusted based on the presence of gastroscope insertion response (coughing or body movement).The study was terminated after observing nine positive-negative crossover points. ED50 and ED95 were calculated using the Probit meth-od. Results All patients completed the procedure successfully without serious adverse events. No significant differences were ob-served between groups regarding age, BMI, ASA classification, baseline HR, mean arterial pressure (MAP), or procedure duration (P> 0.05). In the male group, remimazolam ED50 and ED95 for suppressing gastroscope insertion response were 0.17 mg/kg and 0.21 mg/kg, respectively. In the female group, ED50 and ED95 were 0.14 mg/kg and 0.18 mg/kg, respectively.Conclusion Under combined alfent-anil 6 μg/kg, the ED50 of remimazolam for suppressing gastroscope insertion response was 0.17 mg/kg in male patients and 0.14 mg/kgin female patients, with a male-to-female potency ratio of 1.21. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
