PDF(Pubmed)
Abstract：
Remimazolam is a novel benzodiazepine with sedative and amnestic properties similar to midazolam. Ester metabolism results in a half-life of 5 - 10 min and a limited context sensitive half-life. We present preliminary retrospective experience with its use as a primary agent for procedural sedation for brief invasive and noninvasive procedures. The study cohort included seven patients, ranging in age from 14 to 51 years. Remimazolam administration included bolus dosing in two patients and a combination of bolus dosing followed by an infusion in the other five patients. The initial bolus dose of remimazolam ranged from 2.5 to 5 mg. Starting doses for the infusion ranged from 10 to 30 µg/kg/min with titration of the continuous infusion during the procedure, ranging from 10 - 30 µg/kg/min. Median dose infusion requirements were 15 - 20 µg/kg/min. One procedure was completed with remimazolam as the sole anesthetic agent while the other six patients received adjunctive agents. Changes in blood pressure or oxygen saturation were noted which resolved with minimal interventions such as a decrease in remimazolam infusion rate or an increase in supplemental oxygen administration. Our anecdotal experience provides further support for the efficacy of remimazolam as an agent for procedural sedation.
摘要：
雷米唑仑是一种新型的苯并二氮卓类药物，具有类似于咪达唑仑的镇静和遗忘特性。酯代谢导致5-10分钟的半衰期和有限的环境敏感半衰期。我们提供了初步的回顾性经验，将其用作简短的侵入性和非侵入性手术的程序镇静的主要药物。该研究队列包括7名患者，年龄从14岁到51岁不等。雷马唑仑的给药包括两名患者的推注给药，以及其他五名患者的推注给药组合，然后输注。瑞咪唑仑的初始推注剂量范围为2.5至5mg。输注的起始剂量范围为10至30µg/kg/min，在手术过程中滴定连续输注，范围从10-30微克/千克/分钟。中位剂量输注要求为15-20µg/kg/min。使用雷米咪唑安定作为唯一的麻醉剂完成了一项手术，而其他六名患者则接受了辅助药物。注意到血压或氧饱和度的变化，这些变化可以通过最少的干预措施解决，例如降低瑞马唑仑的输注速率或增加补充氧气的给药。我们的轶事经验为瑞米唑仑作为程序性镇静药物的有效性提供了进一步的支持。
