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The Median Effective Dose and Bispectral Index of Remimazolam Tosilate for Anesthesia Induction in Elderly Patients: An Up-and-Down Sequential Allocation Trial

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机构: [1]Department of Anesthesiology, Capital Medical University Xuanwu Hospital, Beijing, People’s Republic of China [2]Center for Sleep andConsciousness Disorders, Capital Medical University, Beijing, People’s Republic of China [3]Institute of Brain Disorders, Collaborative InnovationCenter for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China
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关键词: remimazolam anesthesia induction geriatric up-and-down sequential allocation

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Purpose: Remimazolam is a new type of ultrashort benzodiazepine drug with an unclear optimal dose for general anesthesia induction in elderly patients aged >60 years. Therefore, this study aimed to determine the effective dose of remimazolam tosilate induction and explore its correlation with the bispectral index (BIS). Patients and Methods: A total of 42 elderly patients were divided into two age groups: 60-69 (group A) and 70-85 (group B) years. An initial dose of 0.1mg/kg(Group A) and 0.05 mg/kg(Group B) remimazolam tosilate was administered, and the Modified Observer's Assessment of Alertness/Sedation scale was used to assess adequate responses. The dose was calculated using the up-and-down allocation technique based on the previous response. The sequential formula and probit regression model were used to calculate ED50 and BIS50. ED95 was determined using the probit regression model. Results: The ED50 of remimazolam tosilate for anesthesia induction were 0.088 mg/kg (95% confidence interval [CI] 0.071-0.108) and 0.061 mg/kg (95% CI 0.053-0.069) in groups A and B, respectively. ED95 was 0.118 mg/kg (95% CI 0.103-0.649) and 0.090 mg/kg (95% CI 0.075-0.199) in groups A and B, respectively. The remimazolam tosilate administration could decrease BIS. BIS50 was 86.0 (95% CI 83.7-88.6) and 85.4 (95% CI 84.1-86.8) in groups A and B, respectively. Conclusion: During the induction process, patients' consciousness should be observed. The dose of remimazolam tosilate could be chosen after careful consideration of individual variations.

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出版当年[2021]版:
大类 | 3 区 医学
小类 | 3 区 老年医学
最新[2025]版:
大类 | 2 区 医学
小类 | 3 区 老年医学
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出版当年[2020]版:
Q2 GERIATRICS & GERONTOLOGY
最新[2023]版:
Q2 GERIATRICS & GERONTOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

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第一作者机构: [1]Department of Anesthesiology, Capital Medical University Xuanwu Hospital, Beijing, People’s Republic of China [2]Center for Sleep andConsciousness Disorders, Capital Medical University, Beijing, People’s Republic of China [3]Institute of Brain Disorders, Collaborative InnovationCenter for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China
通讯作者:
通讯机构: [1]Department of Anesthesiology, Capital Medical University Xuanwu Hospital, Beijing, People’s Republic of China [2]Center for Sleep andConsciousness Disorders, Capital Medical University, Beijing, People’s Republic of China [3]Institute of Brain Disorders, Collaborative InnovationCenter for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China [*1]Department of Anesthesiology, Capital Medical University Xuanwu Hospital, No. 45 Changchun St., Xicheng District, Beijing, 100053, People’s Republic of China
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