Effective remimazolam loading dose for adequate sedation in regional anesthesia
© 2024. Canadian Anesthesiologists' Society..
PURPOSE: Remimazolam is a novel ultrashort-acting sedative considered appropriate for continuous infusion during surgical procedures. Nevertheless, information regarding its loading dose for sedation during surgery is limited. We aimed to determine the 90% effective dose (ED90) of the remimazolam loading dose for sedation in patients undergoing limb surgery under regional anesthesia.
METHODS: We included 50 patients aged 19-80 yr undergoing limb surgery under regional anesthesia. After regional anesthesia, remimazolam besylate was administered at the assigned dose. For ten minutes after the initiation of loading, the level of sedation was evaluated using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale. The primary outcome was the ED90 based on whether patients reached a MOAA/S score of ≤ 3 points (loss of response to verbal command) within ten minutes. The secondary outcomes were the ED50 and the estimated effect site and plasma concentration at the time of achieving successful sedation.
RESULTS: In total, 49 patients were included in the final analysis, and adequate sedation with the assigned loading dose was successful in 42 patients. The log-logistic function showed that the ED90 and ED50 were 0.617 mg·kg-1·hr-1 (95% confidence interval [CI], 0.511 to 0.722; 98% CI, 0.492 to 0.741) and 0.438 mg·kg-1·hr-1 (95% CI, 0.335 to 0.541; 98% CI, 0.315 to 0.560), respectively.
CONCLUSION: The ED90 of the remimazolam loading dose to achieve adequate sedation in patients undergoing limb surgery under regional anesthesia was 0.617 mg·kg-1·hr-1 (95% CI, 0.511 to 0.722; 98% CI, 0.492 to 0.741).
STUDY REGISTRATION: ClinicalTrials.gov (NCT05340335); first posted 22 April 2022.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Canadian journal of anaesthesia = Journal canadien d'anesthesie - (2024) vom: 20. Feb. |
| Sprache: |
Englisch |
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| Weiterer Titel: |
Dose de charge efficace de remimazolam pour une sédation adéquate en anesthésie régionale |
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| Beteiligte Personen: |
Kim, Ha-Jung [VerfasserIn] |
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| Links: |
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| Themen: |
Anesthesia |
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| Anmerkungen: |
Date Revised 21.02.2024 published: Print-Electronic ClinicalTrials.gov: NCT05340335 Citation Status Publisher |
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| doi: |
10.1007/s12630-024-02698-1 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368689581 |
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| 100 | 1 | |a Kim, Ha-Jung |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effective remimazolam loading dose for adequate sedation in regional anesthesia |
| 246 | 3 | 3 | |a Dose de charge efficace de remimazolam pour une sédation adéquate en anesthésie régionale |
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| 500 | |a ClinicalTrials.gov: NCT05340335 | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. Canadian Anesthesiologists' Society. | ||
| 520 | |a PURPOSE: Remimazolam is a novel ultrashort-acting sedative considered appropriate for continuous infusion during surgical procedures. Nevertheless, information regarding its loading dose for sedation during surgery is limited. We aimed to determine the 90% effective dose (ED90) of the remimazolam loading dose for sedation in patients undergoing limb surgery under regional anesthesia | ||
| 520 | |a METHODS: We included 50 patients aged 19-80 yr undergoing limb surgery under regional anesthesia. After regional anesthesia, remimazolam besylate was administered at the assigned dose. For ten minutes after the initiation of loading, the level of sedation was evaluated using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale. The primary outcome was the ED90 based on whether patients reached a MOAA/S score of ≤ 3 points (loss of response to verbal command) within ten minutes. The secondary outcomes were the ED50 and the estimated effect site and plasma concentration at the time of achieving successful sedation | ||
| 520 | |a RESULTS: In total, 49 patients were included in the final analysis, and adequate sedation with the assigned loading dose was successful in 42 patients. The log-logistic function showed that the ED90 and ED50 were 0.617 mg·kg-1·hr-1 (95% confidence interval [CI], 0.511 to 0.722; 98% CI, 0.492 to 0.741) and 0.438 mg·kg-1·hr-1 (95% CI, 0.335 to 0.541; 98% CI, 0.315 to 0.560), respectively | ||
| 520 | |a CONCLUSION: The ED90 of the remimazolam loading dose to achieve adequate sedation in patients undergoing limb surgery under regional anesthesia was 0.617 mg·kg-1·hr-1 (95% CI, 0.511 to 0.722; 98% CI, 0.492 to 0.741) | ||
| 520 | |a STUDY REGISTRATION: ClinicalTrials.gov (NCT05340335); first posted 22 April 2022 | ||
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| 650 | 4 | |a benzodiazepines | |
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| 700 | 1 | |a Park, Hyeok-Seong |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Hwa Jung |e verfasserin |4 aut | |
| 700 | 1 | |a Ro, Young-Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Koh, Won Uk |e verfasserin |4 aut | |
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