Effect of obesity on dose-effect relationship of remimazolam when combined with alfentanil in painless gastroscopy
10.3760/cma.j.cn131073.20220306.00614
- VernacularTitle:肥胖因素对复合阿芬太尼时瑞马唑仑用于无痛胃镜检查术量效关系的影响
- Author:
Pingle LI
1
;
Zhihu YANG
;
Fei XING
;
Qingli ZHANG
;
Yazhuo YUAN
;
Na XING
Author Information
1. 郑州大学第一附属医院麻醉与围术期医学部，郑州 450052
- Keywords:
Obesity;
Alfentanil;
Hypnotics and sedatives;
Gastroscopy;
Dose-response relationship, drug
- From:
Chinese Journal of Anesthesiology
2022;42(6):712-715
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of obesity on the dose-effect relationship of remimazolam when combined with alfentanil in painless gastroscopy.Methods:American Society of Anesthesiologists physical status Ⅰor Ⅱ patients of both sexes, scheduled for elective painless gastroscopy, aged 18-64 yr, were divided into 2 groups according to the body mass index (BMI): normal (BMI 19-24 kg/m 2) group and obese (BMI≥28 kg/m 2) group.Alfentanil 5 μg/kg combined with remimazolam was given intravenously in all the patients, and the dose of remimazolam was determined by the modified Dixon′s up-and-down method.The initial dose of remimazolam was 0.25 mg/kg, and each time the dose was increased or decreased by 0.05 mg/kg based on the sedative effect.The response was defined as positive when the responses that affected the operation of examination developed during insertion of the gastroscope and within the first 2 min of examination such as swallowing, bucking or body movement.This process was repeated until the seventh intersection occurred.The 50% effective dose (ED 50), 95% effective dose (ED 95), and 95% confidence interval ( CI) of remimazolam were calculated by probit method. Results:There were 26 patients in normal group and 18 patients in obese group.The ED 50 (95% CI) of remimazolam was 0.196 (0.087-0.274) mg/kg, and the ED 95 (95% CI) was 0.322 (0.256-1.397) mg/kg in normal group.The ED 50 (95% CI) of remimazolam was 0.125 (0.102-0.148) mg/kg, and the ED 95 (95% CI) was 0.161 (0.141-0.242) mg/kg in obese group.The ED 50 and ED 95 were significantly lower in obese group than in normal group ( P<0.001). Conclusions:Obesity increases the potency of remimazolam when combined with alfentanil 5 μg/kg in the patients undergoing painless gastroscopy.
