Determination Of The Median Effective Dose Of Remimazolam Combined With Oxycodone For Hysteroscopic Surgery By Sequential Method

Objective:To determine the median effective dose(ED50)and 95% effective dose(ED95)of Remimazolam combined with oxycodone in hysteroscopic surgery.Methods:A total of 74 women,aged 18～60 years,American Society of Anesthesiologists(ASA)grade Ⅰ or Ⅱ,who were scheduled to undergo hysteroscopic surgery under total intravenous anesthesia,were randomly divided into remimazolam group(R group)and propofol group(P group).All patients were given oxycodone 0.1 mg/kg as analgesic pretreatment.Dixon improved sequential method was used for the test.Dixon’s up?down method was used for the test.Group R was given remimazolam tosilate for injection intravenously,with the initial dose of 0.2mg/kg,ang the dose gradient was 0.04mg/kg;In group P,propofol medium/long chain fat emulsion injection was injected intravenously,the initial dose was 2 mg/kg,and the dose gradient was 0.4 mg/kg.If the patient has any body movement,frown or improved vigilance/sedation score(MOAA/S score)≥3points during dilatation and endoscopic surgery,the dose of the next patient will increase by 1gradient,otherwise,the next patient will decrease by 1 gradient.The study was terminated when there were seven positive-negative reaction intersections.Probit regression analysis was used to calculate the half effective dose(ED50),95% effective dose(ED95)and95% confidence interval(CI)of remimazolam and propofol respectively.Results:The ED50 of remimazolam combined with oxycodone for hysteroscopic surgery was 0.239(95% CI 0.209～0.272)mg/kg,and the ED95 was 0.325(95% CI 0.285 ～0.513)mg/kg.The ED50 of propofol was 1.767(95% CI 1.358～2.232)mg/kg,and the ED95 was 2.841(95% CI 2.321～6.359)mg/kg.Conclusion:Remimazolam combined with oxycodone can be safely used for anesthesia in hysteroscopic surgery,with fewer adverse reactions,more stable hemodynamics,and faster recovery compared to propofol.The ED50 of Remimazolam combined with oxycodone for hysteroscopic surgery is 0.239mg/kg,which can provide evidence for specific drug administration.