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(ED_(50))。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/m^(2),ASAⅠ或Ⅱ级。根据患者BMI分为四组:正常体重组(C组,19 kg/m^(2)≤BMI<25 kg/m^(2),n=25),偏胖组(D1组,25 kg/m^(2)≤BMI<30 kg/m^(2),n=29),肥胖组(D2组,30 kg/m^(2)≤BMI<35 kg/m^(2),n=26)和重度肥胖组(D3组,35 kg/m^(2)≤BMI<40 kg/m^(2),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ED_(50)和95%可信区间(CI)。结果C组瑞马唑仑引起呼吸抑制的ED_(50)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ED_(50)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ED_(50)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ED_(50)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ED_(50)不同,随着BMI的增加,ED_(50)降低。
Objective To evaluate the median effective dose(ED_(50))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/m^(2),ASA physical statusⅠorⅡ.Patients were divided into 4 groups according to BMI,normal weight group(group C,19 kg/m^(2)≤BMI<25 kg/m^(2),n=25),overweight group(group D1,25 kg/m^(2)≤BMI<30 kg/m^(2),n=29),obesity group(group D2,30 kg/m^(2)≤BMI<35 kg/m^(2),n=26),and severe obesity group(group D3,35 kg/m^(2)≤BMI<40 kg/m^(2),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 ED_(50)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 ED_(50)of remimazolam induced respiratory depression was 0.162 mg/kg(95%CI 0.143-0.183 mg/kg).The ED_(50)of remimazolam induced respiratory depression in group D1 was 0.113 mg/kg(95%CI 0.094-0.136 mg/kg).The ED_(50)of remimazolam induced respiratory depression in group D2 was 0.105 mg/kg(95%CI 0.082-0.136 mg/kg).The ED_(50)of remimazolam induced respiratory depression in group D3 was 0.065 mg/kg(95%CI 0.055-0.085 mg/kg).Conclusion ED_(50)of remimazolam induced respiratory depression was different in patients with different BMI,and the ED_(50)decreased with increasing BMI.
作者
李璐
王晓飞
张伟
张璐瑶
孟凡民
张加强
LI Lu;WANG Xiaofei;ZHANG Wei;ZHANG Luyao;MENG Fanmin;ZHANG Jiaqiang(Department of Anesthesiology and Perioperative Medicine,Henan Provincial People's Hospital,Zhengzhou 450003,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2022年第11期1167-1171,共5页
Journal of Clinical Anesthesiology
基金
河南省医学科技攻关计划省部共建项目(SB201901090)。
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
Remimazolam
Transversus abdominis plane block
Dose-response relationship
Respiratory depression
Obesity
