Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2024.844518
Brazilian Journal of Anesthesiology
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Determination of ED50 and ED95 of remimazolam besylate combined with alfentanil for adult gastroscopy: a prospective dose-finding study

Determinação de ED50 e ED95 de besilato de remimazolam combinado com alfentanil para gastroscopia em adultos: um estudo prospectivo para determinação de dose

Pingjuan Wang, Song Xue, Liufei Zhang, Kunkun Gao, Yiqiao Wang

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Abstract

Background

To explore the median effective dose (ED50) and 95% effective dose (ED95) of remimazolam besylate combined with alfentanil for adult gastroscopy.

Methods

This prospective studyenrolled 31 patients scheduled to painless gastroscopy at Anhui No. 2 Provincial People's Hospital between April and May, 2022. 5 µg.kg−1 of alfentanil hydrochloride was used for pre-analgesia. The initial single loading dose of remimazolam besylate was 0.12 mg.kg−1, increased or reduced by 0.01 mg.kg−1 for the next patient with modified Dixon sequential method. The modified Observer's Assessment of Alertness/Sedation Scale (MOAA/S) was used to assess sedation.

Results

Combined with alfentanil, the ED50 of remimazolam besylate was 0.147 mg.kg−1 (95% CI: 0.138-0.160 mg.kg−1) and ED95 0.171 mg.kg−1 (95% CI: 0.159-0.245 mg.kg−1). The induction time after injection of remimazolam besylate was 70 ± 25 s, with the anesthesia recovery time and the observation time in resuscitation room 5.13 ± 2.13 min and 2.32 ± 1.6 min, respectively.29 patients’ vital signs were within acceptable limits during gastroscopy.

Conclusions

The ED50 of remimazolam besylate combined with alfentanil for painless gastroscopy was 0.147 mg.kg−1, and the ED95 was 0.171 mg.kg−1.

Keywords

Alfentanil Dose Gastroscopy Remimazolam besylate Sequential method

Resumo

Introdução

Explorar a dose eficaz mediana (ED50) e a dose eficaz de 95% (ED95) de besilato de remimazolam combinado com alfentanil para gastroscopia de adultos.

Métodos

Este estudo prospectivo envolveu 31 pacientes agendados para gastroscopia indolor no Hospital Popular Provincial nº 2 de Anhui entre abril e maio de 2022. 5 µg.kg−1 de cloridrato de alfentanil foram usados ​​para pré-analgesia. A dose de ataque única inicial de besilato de remimazolam foi de 0,12 mg.kg−1, aumentada ou reduzida em 0,01 mg.kg−1 para o próximo paciente com método sequencial de Dixon modificado. A Escala de Avaliação de Prontidão/Sedação do Observador modificada (MOAA/S) foi utilizada para avaliar a sedação.

Resultados

Combinado com alfentanil, a DE50 do besilato de remimazolam foi de 0,147 mg.kg-1 (IC 95%: 0,138-0,160 mg.kg-1) e a DE95 de 0,171 mg.kg-1 (IC 95%: 0,159-0,245 mg.kg-1). 1). O tempo de indução após a injeção do besilato de remimazolam foi de 70 ± 25 s, sendo o tempo de recuperação da anestesia e o tempo de observação na sala de reanimação de 5,13 ± 2,13 min e 2,32 ± 1,6 min, respectivamente. Os sinais vitais de vinte e nove pacientes estavam dentro dos limites aceitáveis ​​durante a gastroscopia.

Conclusão

A DE50 do besilato de remimazolam combinado com alfentanil para gastroscopia indolor foi de 0,147 mg.kg-1, e a DE95 foi de 0,171 mg.kg-1.

Palavras-chave

Alfentanil; Dose; Gastroscopia; Besilato de remimazolam; Método sequencial

References

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Submitted date:
08/24/2023

Accepted date:
05/14/2024

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