阿芬太尼联合瑞马唑仑用于纤维支气管镜检查深度镇静的半数有效量和95%有效量

ED_(50)and ED_(95)of Alfentanil combined with Remimazolam for moderate and deep sedation during fiberoptic bronchoscopy

目的计算阿芬太尼与瑞马唑仑用于纤维支气管镜检查深度镇静的半数有效量(ED_(50))和95%有效量(ED_(95))。方法选择拟行纤维支气管镜检查和治疗的患者50例。用试验剂量的阿芬太尼联合瑞马唑仑进行镇静,患者所给予的阿芬太尼剂量依序贯试验法设计,首位患者给予的阿芬太尼剂量为6.000μg/kg。待患者睫毛反射消失,改良警觉/镇静评分(MOAA/S)<1分后,进行纤维支气管镜检查或治疗,记录序贯试验的结果和不良反应发生情况。结果阿芬太尼剂量对数的回归方程为Y=8.9286X-7.6429,阿芬太尼的ED_(50)为7.286μg/kg(95%CI:6.566~8.084),ED_(95)为10.154μg/kg(95%CI:8.753~22.323)。结论阿芬太尼联合瑞马唑仑用于纤维支气管镜检查镇静的ED_(50)为7.286μg/kg,ED_(95)为10.154μg/kg。该镇静方案可以安全、有效地用于纤维支气管镜的检查和治疗中。

Objective To evaluate the safety and efficacy of Alfentanil combined with Remimazolam for moderate and deep sedation in fiberoptic bronchoscopy,and calculate its median effective dose(ED_(50))and 95%effective dose(ED_(95)).Methods 50 patients were selected for fiberoptic bronchoscopy and treatment.Sedation was performed with the test dose of Alfentanil and Remimazolam.After the eyelash reflex disappeared and the MOAA/S score<1,the patients were examined or treated by fiberoptic bronchoscopy.The dose of Alfentanil given to the first patient was 6.000μg/kg,while the dose of Alfentanil used in the other patients was calculated according to the sequential test method.The results of the sequential test and and adverse reactions were recorded.Results All the 50 patients successfully completed the fiberoptic bronchoscopy examination and treatment.According to the results of the sequential test,the Logarithmic regression equation of Alfentanil dose was Y=8.9286X-7.6429,and the ED_(50)for moderate and deep sedation of Alfentanil in fiberoptic bronchoscopy was 7.286μg/kg(95%CI:6.566~8.084)and ED_(95)was 10.154μg/kg(95%CI:8.753~22.323).Conclusion The ED_(50)of Alfentanil for moderate and deep sedation in fiberoptic bronchoscopy was 7.286μg/kg and ED_(95)was 10.154μg/kg.The moderate and deep sedation strategy based on Alfentanil and Remimazolam can be safely and effectively used in the examination and treatment during fiberoptic bronchoscopy.