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| 瑞马唑仑诱发不同BMI患者呼吸抑制的半数有效剂量 |
| Median effective does of remimazolam inducing respiratory depression in patients with different BMI |
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| DOI：10.12089/jca.2022.11.009 |
| 中文关键词: 瑞马唑仑 腹横平面神经阻滞 量-效关系 呼吸抑制 肥胖 |
| 英文关键词: Remimazolam Transversus abdominis plane block Dose-response relationship Respiratory depression Obesity |
| 基金项目:河南省医学科技攻关计划省部共建项目（SB201901090） |
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| 中文摘要: |
目的 探讨瑞马唑仑引起不同BMI患者呼吸抑制的半数有效剂量（ED50）。
方法 选择超声引导下腹横平面神经阻滞患者102例，男48例，女性54例，年龄18～60岁，BMI 19～40 kg/m2，ASA Ⅰ或Ⅱ级。根据患者BMI分为四组：正常体重组（C组，19 kg/m2≤BMI<25 kg/m2，n=25)，偏胖组（D1组，25 kg/m2≤BMI<30 kg/m2，n=29），肥胖组（D2组，30 kg/m2≤BMI<35 kg/m2，n=26）和重度肥胖组（D3组，35 kg/m2≤BMI<40 kg/m2，n=22）。常规消毒铺巾后静脉注射瑞马唑仑，每组患者的第1例均静脉注射0.04 mg/kg（校正体重）、注射时间1 min，下1例患者根据上1例患者的整合呼吸功能指数（IPI）调高或者降低瑞马唑仑剂量，当上一例患者的IPI≥5时，调高瑞马唑仑剂量，当IPI<5时，降低瑞马唑仑剂量，相邻剂量的比值为1.2。根据序贯法分别测定瑞马唑仑对不同BMI患者产生呼吸抑制的ED50和95%可信区间（CI）。
结果 C组瑞马唑仑引起呼吸抑制的ED50为0.162 mg/kg（95%CI 0.143～0.183 mg/kg）。D1组瑞马唑仑引起呼吸抑制的ED50为0.113 mg/kg（95%CI 0.094～0.130 mg/kg）。D2组瑞马唑仑引起呼吸抑制的ED50为0.105 mg/kg（95%CI 0.082～0.136 mg/kg）。D3组瑞马唑仑引起呼吸抑制的ED50为0.065 mg/kg（95%CI 0.055～0.085 mg/kg）。
结论 瑞马唑仑诱发不同BMI患者呼吸抑制的ED50不同，随着BMI的增加，ED50降低。 |
| 英文摘要: |
Ojective To evaluate the median effective dose (ED50) of respiratory depression induced by remimazolam in patients with different BMI.
Methods A total of 102 patients who need ultrasound-guided transversus abdominis plane block under local anesthesia, 48 males and 54 females, aged 18-60 years, BMI 19-40 kg/m2, ASA physical status Ⅰ or Ⅱ. Patients were divided into 4 groups according to BMI, normal weight group (group C, 19 kg/m2 ≤ BMI < 25 kg/m2, n = 25), overweight group (group D1, 25 kg/m2 ≤ BMI < 30 kg/m2, n = 29), obesity group (group D2, 30 kg/m2 ≤ BMI < 35 kg/m2 , n = 26), and severe obesity group (group D3, 35 kg/m2 ≤ BMI < 40 kg/m2, n = 22). After routine disinfection and towel laying, remimazolam was injected intravenously. The first patient in each group was injected intravenously at a rate of 0.04 mg/kg in 1 minute. The next patient will increased or decreased the amount of remimazolam according to the integrated pulmonary index (IPI) of the previous patient. When the IPI of the previous patient was ≥5, we increased the dose of remimazolam. When the IPI was <5, we reduced the dose of remimazolam, and the ratio of adjacent doses was 1.2. According to the sequential method, the ED50 and 95% confidence interval (CI) of remimazolam on the inhibition of ventilatory function in patients with different BMI were measured.
Results In group C, the ED50 of remimazolam induced respiratory depression was 0.162 mg/kg (95% CI 0.143-0.183 mg/kg). The ED50 of remimazolam induced respiratory depression in group D1 was 0.113 mg/kg (95% CI 0.094-0.136 mg/kg). The ED50 of remimazolam induced respiratory depression in group D2 was 0.105 mg/kg (95% CI 0.082-0.136 mg/kg). The ED50 of remimazolam induced respiratory depression in group D3 was 0.065 mg/kg (95% CI 0.055-0.085 mg/kg).
Conclusion ED50 of remimazolam induced respiratory depression was different in patients with different BMI, and the ED50 decreased with increasing BMI. |
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