中国内镜杂志2026，Vol.32Issue(4)：1-11,11.DOI:10.12235/E20250125
苯磺酸瑞马唑仑对行内镜逆行胰胆管造影术患者全身麻醉诱导期艾司氯胺酮半数有效量的影响
Effect of remimazolam besylate on the median effective dose of esketamine during the induction period of general anesthesia in patients undergoing endoscopic retrograde cholangiopancreatography
摘要
Abstract
Objective To investigate the effect of remimazolam besylate on esketamine median effective dose(ED50)during the induction period of endoscopic retrograde cholangiopancreatography(ERCP)under general anesthesia.Methods 102 patients who underwent ERCP under general anesthesia in our hospital from March 2024 to January 2025 were selected for the study.Through stratified random grouping,the patients were divided into R1 group,R2 group and R3 group,with 34 patients in each group.The stress responses,serum pain mediators,hemodynamic indicators before anesthesia induction(T0),during endoscopic insertion(T1),when the duodenal papilla is incised(T2),at the end of the surgery(T3),and 10 min after the operation(T4)in three groups were compared;The anesthesia-related indicators,the ED50 of esketamine and 95％confidence interval(95％CI),and the occurrence of adverse reactions were compared.And draw the sequential diagram of esketamine.The relationship between different doses of remizazolam besylate and the ED50 of esketamine during the induction period of general anesthesia for ERCP was analyzed.Results At time points T1,T2,T3,and T4,as the dose of remimazolam besylate increased,the levels of angiotensin Ⅱ(Ang Ⅱ),norepinephrine(NE),cortisol(Cor),prostaglandin E2(PGE2),substance P(SP),and neuropeptide Y(NPY)in the three groups of patients gradually decreased,but were significantly higher than those at the T0 time point,and the differences were statistically significant(P<0.05).At time points T1,T2 and T3,as the dose of remimazolam besylate increased,the mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR)and percutaneous arterial oxygen saturation(SpO2)levels of the three groups of patients gradually rose,but were significantly lower than those at the T0 time point(P<0.05).As the dose of remimazolam besylate increased,the awakening time and the time to leave the room for the patients in all three groups gradually shortened(P<0.05).The ED50 of esketamine in group R1 was 0.539 mg/kg(95％CI:0.295～0.704),in group R2 it was 0.509 mg/kg(95％CI:0.267～0.695),and in group R3 it was 0.443 mg/kg(95％CI:0.236～0.529).Compared with the R1 group,the anesthesia induction ED50 and 95％drug effective dose(ED95)for ERCP using esketamine in the R2 and R3 groups were significantly lower,and the R3 group was significantly lower than the R2 group.The differences were statistically significant(P<0.05).Conclusion When using compound remimazolam besylate 0.300 mg/kg,the ED50 of esketamine for inducing ERCP under general anesthesia was 0.443 mg/kg.关键词
艾司氯胺酮/苯磺酸瑞马唑仑/麻醉/内镜逆行胰胆管造影术/半数有效量(ED50)Key words
esketamine/remimazolam besylate/anesthesia/endoscopic retrograde cholangiopancreatography/median effective dose(ED50)分类
医药卫生引用本文复制引用
屠亚君,伊利亚尔·买买提力,谢妍..苯磺酸瑞马唑仑对行内镜逆行胰胆管造影术患者全身麻醉诱导期艾司氯胺酮半数有效量的影响[J].中国内镜杂志,2026,32(4):1-11,11.基金项目
上海市徐汇区卫生健康委员会项目(SHXHZDXK202324) （SHXHZDXK202324）
