Effect of Remimazolam Supplementation on Propofol Requirements During Hysteroscopy: A Double-Blind, Dose-Response Study

医学 异丙酚 镇静 宫腔镜检查 丸(消化) 麻醉 宫颈扩张术 舒芬太尼 置信区间 外科 内科学 怀孕 妊娠期 生物 遗传学
作者
Yanhong Zhou,Shu-Xi Li,Lin Li,Chun-Mei Deng,Jianjun Shen,Dong‐Xin Wang,Xinzhong Chen,Lili Xu
出处
期刊:Anesthesia & Analgesia [Lippincott Williams & Wilkins]
卷期号:139 (6): 1309-1316 被引量:6
标识
DOI:10.1213/ane.0000000000006921
摘要

BACKGROUND: Propofol is commonly used for procedural sedation but may increase side effects in a dose-dependent manner. Remimazolam, an ultrashort-acting benzodiazepine, has been approved for procedural sedation but may delay awakening. This study tested the hypothesis that remimazolam as a supplement reduces effect-site propofol concentration (Ce prop ) required to suppress response to cervical dilation in patients undergoing hysteroscopy. METHODS: One hundred and fifty patients who were scheduled for hysteroscopy were randomized to receive 0, 0.05, 0.1, 0.15, or 0.2 mg·kg –1 intravenous remimazolam, followed by a bolus of sufentanil 0.15 μg⋅kg –1 , and a target-controlled propofol infusion. The initial target Ce prop was 3.5 μg·mL –1 and was increased or decreased in subsequent patients by steps of 0.5 μg·mL –1 according to whether there was loss of response to cervical dilation in the previous patient. We used up-down sequential analysis to determine values of Ce prop that suppressed response to cervical dilation in 50% of patients (EC 50 ). RESULTS: The EC 50 of propofol for suppressing response to cervical dilation was lower in patients given 0.1 mg·kg –1 (2.08 [95% confidence interval, CI, 1.88–2.28] μg·mL –1 ), 0.15 mg⋅kg –1 (1.83 [1.56–2.10] μg·mL –1 ), and 0.2 mg⋅kg –1 (1.43 [1.27–1.58] μg·mL –1 ) remimazolam than those given 0 mg⋅kg –1 (3.67 [3.49–3.86] μg·mL –1 ) or 0.05 mg⋅kg –1 (3.47 [3.28–3.67] μg·mL –1 ) remimazolam (all were P < .005). Remimazolam at doses of 0.1, 0.15, and 0.2 mg·kg –1 decreased EC 50 of propofol by 43.3% (95% CI, 41.3%–45.5%), 50.3% (48.0%–52.8%), and 61.2% (58.7%–63.8%), respectively, from baseline (remimazolam 0 mg⋅kg –1 ). Propofol consumption was lower in patients given 0.1 mg⋅kg –1 (4.15 [3.51–5.44] mg·kg –1 ), 0.15 mg⋅kg –1 (3.54 [3.16–4.46] mg·kg –1 ), and 0.2 mg⋅kg –1 (2.74 [1.73–4.01] mg·kg –1 ) remimazolam than those given 0 mg⋅kg –1 (6.09 [4.99–7.35] mg·kg –1 ) remimazolam (all were P < .005). Time to anesthesia emergence did not differ significantly among the 5 groups. CONCLUSIONS: For women undergoing hysteroscopic procedures, remimazolam at doses from 0.1 to 0.2 mg·kg –1 reduced the EC 50 of propofol inhibiting response to cervical dilation and the total propofol requirement. Whether the combination could improve perioperative outcomes deserves further investigation.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
冷静的梦芝完成签到 ,获得积分10
1秒前
英姑应助晚来天欲雪采纳,获得10
1秒前
XJ发布了新的文献求助10
1秒前
2秒前
XiaoMing发布了新的文献求助30
2秒前
悦耳易烟完成签到,获得积分20
3秒前
3秒前
wqy发布了新的文献求助10
4秒前
luoshikun发布了新的文献求助10
4秒前
烟花应助c57采纳,获得10
5秒前
喜喵喵发布了新的文献求助30
5秒前
纪富完成签到 ,获得积分10
5秒前
深情安青应助知性的雪糕采纳,获得10
5秒前
小白白发布了新的文献求助10
6秒前
虚幻的莞完成签到,获得积分10
7秒前
Sihan完成签到,获得积分10
8秒前
OULA!发布了新的文献求助20
9秒前
科研通AI5应助hh采纳,获得10
12秒前
12秒前
12秒前
0526Test发布了新的文献求助10
13秒前
Lucas应助清逸采纳,获得10
13秒前
Duduk完成签到,获得积分10
13秒前
14秒前
15秒前
16秒前
852应助OULA!采纳,获得10
18秒前
极大张希希完成签到 ,获得积分10
19秒前
19秒前
Akim应助王染墨采纳,获得10
20秒前
Niu发布了新的文献求助10
22秒前
23秒前
23秒前
深情安青应助zz采纳,获得10
24秒前
滑步小镰刀完成签到,获得积分20
25秒前
27秒前
27秒前
28秒前
28秒前
阡陌完成签到 ,获得积分10
28秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3976126
求助须知:如何正确求助?哪些是违规求助? 3520340
关于积分的说明 11202586
捐赠科研通 3256847
什么是DOI,文献DOI怎么找? 1798509
邀请新用户注册赠送积分活动 877645
科研通“疑难数据库(出版商)”最低求助积分说明 806516