目的:雷马唑仑,以其快速起病而闻名,快速新陈代谢,镇静恢复时间短,在临床麻醉中具有显著的优势。以前的研究主要研究了其在成人手术麻醉中的应用,较少关注其在儿科患者中的应用。因此,我们旨在探讨在小儿斜视矫正术中全身麻醉期间插入喉罩(LMA)的50%有效剂量(ED50)和95%有效剂量(ED95)的瑞咪唑安定,并探讨其剂量-反应关系,从而为更安全、更合理的临床用药提供有价值的参考数据。
方法:本研究纳入了2024年在宁波爱尔光明眼科医院接受斜视矫正手术的32例3-12岁患者。根据Dixon“上下”序贯方法确定了瑞咪唑仑的剂量:起始诱导剂量为0.2mg/kg,步骤剂量为0.05mg/kg。在麻醉效果积极的情况下,随后的患者接受了减少的阶梯剂量,而在负面麻醉效果的情况下,下一个受试者接受增加的阶梯剂量。在观察到七个“阳性-阴性”交叉点后终止试验。此外,使用Probit回归分析计算ED50和ED95及其95%置信区间(95%CI).此外,病人的生命体征,如外周氧(SpO2),心率,还有血压,随着不良事件的发生,被监控。
结果:在儿童斜视矫正手术中用于LMA插入的雷米马唑仑的ED50为0.300mg/kg(95%CI0.276-0.323mg/kg),ED95为0.369mg/kg(95%CI0.324-0.414mg/kg)。在整个手术中,血氧饱和度,心率,血压保持稳定,无明显波动。
结论:在儿童斜视矫正手术中,用于LMA插入的瑞咪唑安定的ED50和ED95分别为0.300mg/kg和0.369mg/kg,分别。这项研究表明,在小儿斜视矫正手术的全身麻醉中,雷米咪唑安定对于LMA插入既安全又有效。
OBJECTIVE: Remimazolam, known for its rapid onset, quick metabolism, and short recovery time from sedation, offers significant advantages in clinical anesthesia. Previous studies have primarily investigated its application in adult surgical anesthesia, with less focus on its utilization in pediatric patients. Therefore, we aimed to explore the 50% effective dose (ED50) and 95% effective dose (ED95) of remimazolam for laryngeal mask airway (LMA) insertion during general anesthesia in pediatric strabismus correction surgery and investigate its dose-response relationship, thereby providing valuable reference data for safer and more rational clinical use of remimazolam.
METHODS: This study included 32 patients aged 3-12 years undergoing strabismus correction surgery at Ningbo Aier Guangming Eye Hospital in 2024. The dosage of remimazolam was determined according to the Dixon \'up-and-down\' sequential method: the starting induction dose was 0.2 mg/kg, with a step dose of 0.05 mg/kg. In cases of positive anesthetic effect, the subsequent patient received a reduced step dose, while in cases of negative anesthetic effect, the next subject received an increased step dose. The trial was terminated upon observing seven \"positive-negative\" crossover points. Furthermore, the ED50 and ED95, along with their 95% confidence intervals (95% CI) were calculated using the Probit regression analysis. Additionally, vital signs of the patients, such as peripheral oxygen (SpO2), heart rate, and blood pressure, along with the incidence of adverse events, were monitored.
RESULTS: The ED50 of remimazolam for LMA insertion in pediatric strabismus correction surgery was 0.300 mg/kg (95% CI 0.276-0.323 mg/kg), and the ED95 was 0.369 mg/kg (95% CI 0.324-0.414 mg/kg). Throughout the surgery, SpO2, heart rate, and blood pressure remained stable without any significant fluctuations.
CONCLUSIONS: The ED50 and ED95 of remimazolam for LMA insertion in pediatric strabismus correction surgery are 0.300 mg/kg and 0.369 mg/kg, respectively. This study demonstrates that remimazolam is both safe and effective for LMA insertion during general anesthesia in pediatric strabismus correction surgery.