Efficacy of Single-Bolus Administration of Remimazolam During Induction of Anesthesia in Patients Undergoing Cardiac Surgery: A Prospective, Single-Center, Randomized Controlled Study.

IF 4.6 2区 医学 Q1 ANESTHESIOLOGY Anesthesia and analgesia Pub Date : 2024-10-01 Epub Date: 2024-02-05 DOI:10.1213/ANE.0000000000006861
Sou-Hyun Lee, Jae-Sik Nam, Dae-Kee Choi, Ji-Hyun Chin, In-Cheol Choi, Kyungmi Kim
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Abstract

Background: Remimazolam is a recently marketed ultrashort-acting benzodiazepine. This drug is considered safe and effective during general anesthesia; however, limited information is available about its effects on patients undergoing cardiac surgery. Therefore, the present study was conducted to evaluate the efficacy and hemodynamic stability of a bolus administration of remimazolam during anesthesia induction in patients undergoing cardiac surgery.

Methods: Patients undergoing elective cardiac surgery were randomly assigned to any 1 of the following 3 groups: anesthesia induction with a continuous infusion of remimazolam 6 mg/kg/h (continuous group), a single-bolus injection of remimazolam 0.1 mg/kg (bolus 0.1 group), or a single-bolus injection of remimazolam 0.2 mg/kg (bolus 0.2 group). Time to loss of responsiveness, defined as modified Observer's Assessment of Alertness/Sedation Scale <3, and changes in hemodynamic status during anesthetic induction were measured.

Results: Times to loss of responsiveness were 137 ± 20, 71 ± 35, and 48 ± 9 seconds in the continuous, bolus 0.1, and bolus 0.2 groups, respectively. The greatest mean difference was observed between the continuous and bolus 0.2 groups (89.0, 95% confidence interval [CI], 79.1-98.9), followed by the continuous and bolus 0.1 groups (65.8, 95% CI, 46.9-84.7), and lastly between the bolus 0.2 and bolus 0.1 groups (23.2, 95% CI, 6.6-39.8). No significant differences were found in terms of arterial blood pressures and heart rates of the patients.

Conclusions: A single-bolus injection of remimazolam provided efficient anesthetic induction in patients undergoing cardiac surgery. A 0.2 mg/kg bolus injection of remimazolam resulted in the shortest time to loss of responsiveness among the 3 groups, without significantly altering the hemodynamic parameters. Therefore, this dosing can be considered a favorable anesthetic induction method for patients undergoing cardiac surgery.

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心脏手术患者在麻醉诱导期间单次服用雷马唑仑的疗效:一项前瞻性、单中心、随机对照研究。
背景介绍雷马唑仑是最近上市的一种超短效苯并二氮杂卓。这种药物在全身麻醉中被认为是安全有效的,但有关其对心脏手术患者影响的信息却很有限。因此,本研究旨在评估心脏手术患者麻醉诱导期间栓塞给药瑞马唑仑的疗效和血液动力学稳定性:接受择期心脏手术的患者被随机分配到以下3组中的任意一组:持续输注6 mg/kg/h的雷马唑仑(持续组)、单次注射0.1 mg/kg的雷马唑仑(栓剂0.1组)或单次注射0.2 mg/kg的雷马唑仑(栓剂0.2组)进行麻醉诱导。反应性丧失时间,定义为改良的观察者警觉性评估/镇静量表结果:持续组、栓剂 0.1 组和栓剂 0.2 组的反应消失时间分别为 137 ± 20 秒、71 ± 35 秒和 48 ± 9 秒。连续用药组和栓剂 0.2 组的平均差异最大(89.0,95% 置信区间 [CI],79.1-98.9),其次是连续用药组和栓剂 0.1 组(65.8,95% CI,46.9-84.7),最后是栓剂 0.2 组和栓剂 0.1 组(23.2,95% CI,6.6-39.8)。患者的动脉血压和心率无明显差异:结论:对接受心脏手术的患者来说,单次栓剂注射雷马唑仑可提供高效的麻醉诱导。在三组患者中,0.2 毫克/千克栓剂注射雷马唑仑使患者在最短时间内丧失反应能力,且不会明显改变血液动力学参数。因此,这种剂量可被视为对心脏手术患者有利的麻醉诱导方法。
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来源期刊
Anesthesia and analgesia
Anesthesia and analgesia 医学-麻醉学
CiteScore
9.90
自引率
7.00%
发文量
817
审稿时长
2 months
期刊介绍: Anesthesia & Analgesia exists for the benefit of patients under the care of health care professionals engaged in the disciplines broadly related to anesthesiology, perioperative medicine, critical care medicine, and pain medicine. The Journal furthers the care of these patients by reporting the fundamental advances in the science of these clinical disciplines and by documenting the clinical, laboratory, and administrative advances that guide therapy. Anesthesia & Analgesia seeks a balance between definitive clinical and management investigations and outstanding basic scientific reports. The Journal welcomes original manuscripts containing rigorous design and analysis, even if unusual in their approach.
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