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Pharmacodynamic analysis of intravenous bolus remimazolam for loss of consciousness in patients undergoing general anaesthesia: a randomised, prospective, double-blind study

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dc.contributor.author김현창-
dc.contributor.author송영-
dc.contributor.author채동우-
dc.contributor.author한동우-
dc.date.accessioned2022-08-23T00:28:58Z-
dc.date.available2022-08-23T00:28:58Z-
dc.date.issued2022-07-
dc.identifier.issn0007-0912-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/189454-
dc.description.abstractBackground: Remimazolam is a new rapid offset benzodiazepine used for procedural sedation and general anaesthesia. This study evaluated the efficacy and safety of i.v. bolus remimazolam during induction of anaesthesia. Methods: A total of 120 patients undergoing general anaesthesia were randomly allocated into six dose groups (n=20) of i.v. bolus remimazolam (0.02-0.27 mg kg-1). Loss of consciousness, respiratory depression, patient state index (PSI), and haemodynamic variables were evaluated during anaesthetic induction. Parametric time-to-event models were used to identify the 50% effective dose (ED50)/95% effective dose (ED95) associated with loss of consciousness and respiratory depression. Non-linear mixed-effect models analysed the PSI and haemodynamic changes after i.v. bolus remimazolam. Results: Loss of consciousness and respiratory depression onset showed steep dose-responses with ED50/ED95 of 0.11/0.19 and 0.14/0.27 mg kg-1 and Hill coefficients of 5.3 and 4.6, respectively. Older age was significantly associated with lower ED50/ED95 for both endpoints. ED50/ED95 and the Hill coefficient of PSI decline were 0.12/0.68 mg kg-1 and 1.7, respectively. We propose optimal doses of 0.25-0.33, 0.19-0.25, and 0.14-0.19 mg kg-1 in patients aged <40, 60-80, and >80 yr, respectively, based on the ED95 estimates for the corresponding age groups. The maximum percentage reduction of MAP was 27.8% and the ED50/ED95 were 0.14/2.60 mg kg-1. The effect of remimazolam on heart rate was insignificant. Conclusions: The ED50/ED95s of i.v. bolus remimazolam were successfully estimated from the time to loss of consciousness and respiratory depression. No serious adverse events occurred within the range of tested doses. Clinical trial registration: NCT04901871.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherOxford University Press-
dc.relation.isPartOfBRITISH JOURNAL OF ANAESTHESIA-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAnesthesia, General-
dc.subject.MESHBenzodiazepines / adverse effects-
dc.subject.MESHDose-Response Relationship, Drug-
dc.subject.MESHDouble-Blind Method-
dc.subject.MESHHumans-
dc.subject.MESHHypnotics and Sedatives / pharmacology-
dc.subject.MESHMidazolam* / therapeutic use-
dc.subject.MESHProspective Studies-
dc.subject.MESHRespiratory Insufficiency* / chemically induced-
dc.subject.MESHUnconsciousness / chemically induced-
dc.titlePharmacodynamic analysis of intravenous bolus remimazolam for loss of consciousness in patients undergoing general anaesthesia: a randomised, prospective, double-blind study-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Anesthesiology and Pain Medicine (마취통증의학교실)-
dc.contributor.googleauthorDongwoo Chae-
dc.contributor.googleauthorHyun-Chang Kim-
dc.contributor.googleauthorYoung Song-
dc.contributor.googleauthorYoung Seo Choi-
dc.contributor.googleauthorDong Woo Han-
dc.identifier.doi10.1016/j.bja.2022.02.040-
dc.contributor.localIdA06091-
dc.contributor.localIdA02036-
dc.contributor.localIdA04014-
dc.contributor.localIdA04274-
dc.relation.journalcodeJ00405-
dc.identifier.eissn1471-6771-
dc.identifier.pmid35562226-
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S0007091222001581?via%3Dihub-
dc.subject.keywordbenzodiazepines-
dc.subject.keywordconsciousness-
dc.subject.keywordgeneral anaesthesia-
dc.subject.keywordremimazolam-
dc.subject.keywordrespiratory depression-
dc.contributor.alternativeNameKim, Hyun-Chang-
dc.contributor.affiliatedAuthor김현창-
dc.contributor.affiliatedAuthor송영-
dc.contributor.affiliatedAuthor채동우-
dc.contributor.affiliatedAuthor한동우-
dc.citation.volume129-
dc.citation.number1-
dc.citation.startPage49-
dc.citation.endPage57-
dc.identifier.bibliographicCitationBRITISH JOURNAL OF ANAESTHESIA, Vol.129(1) : 49-57, 2022-07-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers

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