Determination of the 95% effective dose of remimazolam to achieve loss of consciousness during anesthesia induction in different age groups
Background Remimazolam is a new ultra short-acting benzodiazepine originally developed as an improved version of midazolam. Recent studies have demonstrated non-inferiority of remimazolam to propofol in general anesthesia. However, to date, few studies have investigated the induction bolus dose of r...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Anesthesiologists
2022-12-01
|
| Series: | Korean Journal of Anesthesiology |
| Subjects: | |
| Online Access: | http://ekja.org/upload/pdf/kja-22331.pdf |
| _version_ | 1828097913002131456 |
|---|---|
| author | Juyeon Oh Sung Yong Park Sook Young Lee Ju Yeol Song Ga Yun Lee Ji Hyun Park Han Bum Joe |
| author_facet | Juyeon Oh Sung Yong Park Sook Young Lee Ju Yeol Song Ga Yun Lee Ji Hyun Park Han Bum Joe |
| author_sort | Juyeon Oh |
| collection | DOAJ |
| description | Background Remimazolam is a new ultra short-acting benzodiazepine originally developed as an improved version of midazolam. Recent studies have demonstrated non-inferiority of remimazolam to propofol in general anesthesia. However, to date, few studies have investigated the induction bolus dose of remimazolam required to achieve general anesthesia. We aimed to determine the 95% effective dose (ED95) of remimazolam bolus required to achieve loss of consciousness (LOC) and the appropriate doses for different age groups. Methods Patients aged 20–79 years with the American Society of Anesthesiologists physical status of I or II were enrolled in this study. A total of 120 patients were included representing young, middle-aged, and elderly groups. Loss of eyelash reflex and verbal response after the administration of remimazolam was considered successful LOC. The ED95 of remimazolam was determined using a biased coin up-and-down design with sequential allocation and the isotonic regression method. Results The ED95 of remimazolam for induction of general anesthesia was 0.367 mg/kg (95% CI [0.277, 0.392]) in the young group, 0.369 mg/kg (95% CI [0.266, 0.394]) in the middle-aged group, and 0.249 mg/kg (95% CI [0.199, 0.288]) in the elderly group. During the study period, none of the patients required rescue medications for hypotension or bradycardia. Conclusions This study investigated the ED95 of remimazolam bolus for anesthesia induction. The precise dosing of the ED95 can help maintain hemodynamic stability during the induction of anesthesia. |
| first_indexed | 2024-04-11T07:53:26Z |
| format | Article |
| id | doaj.art-1b3be443692d40eaa786a25221c00aad |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-04-11T07:53:26Z |
| publishDate | 2022-12-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-1b3be443692d40eaa786a25221c00aad2022-12-22T04:35:59ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632022-12-0175651051710.4097/kja.223318828Determination of the 95% effective dose of remimazolam to achieve loss of consciousness during anesthesia induction in different age groupsJuyeon Oh0Sung Yong Park1Sook Young Lee2Ju Yeol Song3Ga Yun Lee4Ji Hyun Park5Han Bum Joe6 Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea Office of Biostatics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Korea Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, KoreaBackground Remimazolam is a new ultra short-acting benzodiazepine originally developed as an improved version of midazolam. Recent studies have demonstrated non-inferiority of remimazolam to propofol in general anesthesia. However, to date, few studies have investigated the induction bolus dose of remimazolam required to achieve general anesthesia. We aimed to determine the 95% effective dose (ED95) of remimazolam bolus required to achieve loss of consciousness (LOC) and the appropriate doses for different age groups. Methods Patients aged 20–79 years with the American Society of Anesthesiologists physical status of I or II were enrolled in this study. A total of 120 patients were included representing young, middle-aged, and elderly groups. Loss of eyelash reflex and verbal response after the administration of remimazolam was considered successful LOC. The ED95 of remimazolam was determined using a biased coin up-and-down design with sequential allocation and the isotonic regression method. Results The ED95 of remimazolam for induction of general anesthesia was 0.367 mg/kg (95% CI [0.277, 0.392]) in the young group, 0.369 mg/kg (95% CI [0.266, 0.394]) in the middle-aged group, and 0.249 mg/kg (95% CI [0.199, 0.288]) in the elderly group. During the study period, none of the patients required rescue medications for hypotension or bradycardia. Conclusions This study investigated the ED95 of remimazolam bolus for anesthesia induction. The precise dosing of the ED95 can help maintain hemodynamic stability during the induction of anesthesia.http://ekja.org/upload/pdf/kja-22331.pdfgeneral anesthesiahypnotics and sedativesintravenous anesthesiaremimazolamunconsciousnessvital signs |
| spellingShingle | Juyeon Oh Sung Yong Park Sook Young Lee Ju Yeol Song Ga Yun Lee Ji Hyun Park Han Bum Joe Determination of the 95% effective dose of remimazolam to achieve loss of consciousness during anesthesia induction in different age groups Korean Journal of Anesthesiology general anesthesia hypnotics and sedatives intravenous anesthesia remimazolam unconsciousness vital signs |
| title | Determination of the 95% effective dose of remimazolam to achieve loss of consciousness during anesthesia induction in different age groups |
| title_full | Determination of the 95% effective dose of remimazolam to achieve loss of consciousness during anesthesia induction in different age groups |
| title_fullStr | Determination of the 95% effective dose of remimazolam to achieve loss of consciousness during anesthesia induction in different age groups |
| title_full_unstemmed | Determination of the 95% effective dose of remimazolam to achieve loss of consciousness during anesthesia induction in different age groups |
| title_short | Determination of the 95% effective dose of remimazolam to achieve loss of consciousness during anesthesia induction in different age groups |
| title_sort | determination of the 95 effective dose of remimazolam to achieve loss of consciousness during anesthesia induction in different age groups |
| topic | general anesthesia hypnotics and sedatives intravenous anesthesia remimazolam unconsciousness vital signs |
| url | http://ekja.org/upload/pdf/kja-22331.pdf |
| work_keys_str_mv | AT juyeonoh determinationofthe95effectivedoseofremimazolamtoachievelossofconsciousnessduringanesthesiainductionindifferentagegroups AT sungyongpark determinationofthe95effectivedoseofremimazolamtoachievelossofconsciousnessduringanesthesiainductionindifferentagegroups AT sookyounglee determinationofthe95effectivedoseofremimazolamtoachievelossofconsciousnessduringanesthesiainductionindifferentagegroups AT juyeolsong determinationofthe95effectivedoseofremimazolamtoachievelossofconsciousnessduringanesthesiainductionindifferentagegroups AT gayunlee determinationofthe95effectivedoseofremimazolamtoachievelossofconsciousnessduringanesthesiainductionindifferentagegroups AT jihyunpark determinationofthe95effectivedoseofremimazolamtoachievelossofconsciousnessduringanesthesiainductionindifferentagegroups AT hanbumjoe determinationofthe95effectivedoseofremimazolamtoachievelossofconsciousnessduringanesthesiainductionindifferentagegroups |