丙泊酚增强全身麻醉诱导期甲苯磺酸瑞马唑仑镇静深度的有效剂量观察

Effective Dose of Propofol Enhanced Sedation Depth of Remimazolam Tosilate During Induction of General Anesthesia

目的确定丙泊酚增强全身麻醉诱导期甲苯磺酸瑞马唑仑(简称瑞马唑仑)镇静深度的半数有效剂量(ED_(50))和95%有效剂量(ED_(95))。方法选择在全身麻醉下行手术的患者,性别不限,年龄18~64岁,体质量50~80 kg,美国麻醉医师协会(ASA)分级Ⅰ级或Ⅱ级。采用序贯法进行试验。静脉注射舒芬太尼0.4μg/kg,米库氯铵0.2 mg/kg,瑞马唑仑0.3 mg/kg,设定丙泊酚初始剂量0.65 mg/kg,如果BIS值≤48,则下一例丙泊酚用量降低1个剂量梯度;若BIS值>48,在下一例增加1个剂量梯度。采用Probit法计算丙泊酚增强全身麻醉诱导期瑞马唑仑镇静深度的ED_(50)、ED_(95)及其95%置信区间(95%CI)。结果丙泊酚增强全身麻醉诱导期瑞马唑仑镇静深度的ED_(50)为0.45 mg/kg,95%CI为(0.42~0.49)mg/kg;ED_(95)为0.53 mg/kg,95%CI为(0.49~0.71)mg/kg。结论小剂量丙泊酚复合瑞马唑仑全麻诱导,在满足镇静深度的同时能较好维持血流动力学的稳定,丙泊酚增强全身麻醉诱导期瑞马唑仑镇静深度的ED_(50)为0.45 mg/kg,ED_(95)为0.53 mg/kg。

Objective To determine the median effective dose(ED_(50))and 95%effective dose(ED_(95))of propofol to enhance sedation depth of remimazolam tosilate(RMZ)during induction period of general anesthesia.Methods Patients who aged 18~64 years old with weighing 50~80 kg were enrolled.American Society of Anesthesiologists(ASA)hadⅠorⅡgrade.Sequential method was used to test.Anesthesia was induced with intravenous injection of sufentanil 0.4μg/kg,micuronium chloride 0.2 mg/kg,and RMZ 0.3 mg/kg.The initial dose of propofol was set as 0.65 mg/kg.If BIS≤48,dosage of propofol in the next case was reduced by one dose gradient.If BIS>48,a dose gradient was increased in the next case.Probit method analysis was used to calculate ED_(50),ED_(95) and 95%confidence interval(95%CI)of propofol enhanced sedation depth of BMZ during induction of general anesthesia.Results The ED_(50),ED_(95),and 95%CI of propofol enhanced sedation depth of BMZ during induction of general anesthesia were 0.45 mg/kg,(0.42~0.49)mg/kg and 0.53 mg/kg,(0.49~0.71)mg/kg,respectively.Conclusion Low dose propofol combined with RMZ could maintain hemodynamic stability while satisfying sedation depth.The ED_(50) and ED_(95) of propofol enhanced sedation depth of RMZ during induction of general anesthesia are 0.45 mg/kg and 0.53 mg/kg,respectively.