Article(id=1292126416519328163, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126377440989952, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2026.01.004, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1747670400000, receivedDateStr=2025-05-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785996544245, onlineDateStr=2026-08-06, pubDate=1768579200000, pubDateStr=2026-01-17, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785996544245, onlineIssueDateStr=2026-08-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785996544245, creator=13701087609, updateTime=1785996544245, updator=13701087609, issue=Issue{id=1292126377440989952, tenantId=1146029695717560320, journalId=1246415772164075586, year='2026', volume='42', issue='1', pageStart='1', pageEnd='147', issueExtLink='null', onlineDate='null', pubDate='1768579200000', pubDateStr='2026-01-17', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785996534929, creator='13701087609', updateTime=1786014708731, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1292202603945947673, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126377440989952, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1292202603950141978, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126377440989952, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=22, endPage=27, ext={EN=ArticleExt(id=1292126416716460452, articleId=1292126416519328163, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical trial of remimazolam combined with fentanyl in general anesthesia for pediatric laparoscopic hernia repair surgery, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To observe the clinical efficacy and safety of remimazolam injection combined with fentanyl injection in the induction of general anesthesia for pediatric laparoscopic hernia surgery.
Methods The children who underwent elective laparoscopic hernia surgery in our hospital were divided into successful sedation group and failed sedation group according to whether laryngeal mask placement was completed under sedation remedy. Remimazolam injection was administered intravenously, using an initial dose of 0.3 mg·kg-1 with a dose increment of 0.05 mg·kg-1. The dose for the next patient was determined according to the modified Dixon sequential method. Patients who successfully underwent laryngeal mask insertion were included in the sedation success group, while those requiring additional intravenous propofol for sedation to complete laryngeal mask insertion were included in the sedation failure group. Remimazolam injection combined with fentanyl injection was calculated by modified Probit regression for the induction of half effective dose (ED50) and 95% effective dose (ED95) and its 95% confidence interval (CI) in pediatric laparoscopic hernia induction of general anesthesia. Recorded vital signs during anesthesia induction, preoperative, dosage and intraoperative procedures, and evaluated for safety.
Results A total of 42 children who were planned for laparoscopic hernia surgery were screened in this study, of which were excluded due to abnormal preoperative examination (4 cases), parental refusal to participate (2 cases) and difficult airway (1 case), and finally, 35 hospitalized children who met the criteria were included. All enrolled children successfully completed the study process and no case dropped out, 18 cases of successful sedation and 17 cases of failed sedation. The ED50 of remimazolam combined with fentanyl for general anesthesia induction in pediatric laparoscopic surgery was 0.22 mg·kg-1, CI was (0.19~0.26), ED95 was 0.32 mg·kg-1, and CI was (0.28~0.51). The time from anesthesia induction to intubation in the successful and failed sedation groups were 4.58 (3.00, 5.00) and 4.63 (3.25, 5.75) min, respectively; the time of surgery were 13.63 (7.00, 17.00) and 14.00 (6.50, 18.00) min, respectively; the time from discontinuation to extubation were 17.84 (7.00, 21.00) and 16.50 (6.40, 22.75) min, respectively; and the stay time after resuscitation were 38.42 (30.00, 40.00) and 41.56 (22.10, 49.25) min, respectively. There was no significant difference between the above indicators in the successful sedation group and the failed sedation group (all P>0.05). The main adverse drug reactions in the successful sedation group were drowsiness, hypotension and hypoxemia, and in the sedation failure group were drowsiness and hypotension. The total incidence of adverse drug reactions in the successful sedation group and the failed sedation group were 22.22% (4 cases/18 cases) and 17.65% (3 cases/17cases). There was no significant difference between the above indicators in the successful sedation group and the failed sedation group (P>0.05).
Conclusion The ED50 of remimazolam combined with fentanyl for inserting a laryngeal mask in pediatric general anesthesia is 0.22 mg·kg-1, with a CI of (0.19~0.26).
, authors=Ru LI, Xiao JIN, authorsList=Ru LI, Xiao JIN, authorCompany=null, correspAuthors=Xiao JIN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1292126416984895909, articleId=1292126416519328163, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=瑞马唑仑联合芬太尼用于小儿腹腔镜疝气手术全身麻醉的临床研究, columnId=1246531407485489349, journalTitle=中国临床药理学杂志, columnName=临床与基础桥接研究, runingTitle=null, highlight=null, articleAbstract=
目的 观察瑞马唑仑注射液联合芬太尼注射液用于小儿腹腔镜疝气手术全身麻醉诱导的临床疗效和安全性。
方法 将我院择期行腹腔镜疝气手术的患儿按是否需要镇静补救下完成喉罩置入术分为镇静成功组和镇静失败组。0.3 mg·kg-1瑞马唑仑注射液作为起始量，剂量梯度为0.05 mg·kg-1，根据改良Dixon序贯法决定下1例患儿的瑞马唑仑注射液剂量。将成功进行喉罩置入者纳入镇静成功组，需静脉推注丙泊酚注射液进行镇静补救下完成喉罩置入者纳入镇静失败组。通过改良Probit回归计算瑞马唑仑注射液联合芬太尼注射液用于小儿腹腔镜疝气全身麻醉诱导半数有效量（ED50）和95%有效量（ED95）及其95%置信区间（CI）。记录麻醉诱导、药物剂量、术前及术中的生命体征，并进行安全性评价。
结果 本研究共筛选42例拟行腹腔镜疝气手术的患儿，其中因术前检查异常（4例）、家长拒绝参与（2例）、困难气道（1例）被排除，最终纳入符合标准的35例住院患儿。所有入组患儿均顺利完成研究流程，无病例脱落。镇静成功18例，镇静失败17例。瑞马唑仑联合芬太尼用于小儿腹腔镜手术全麻诱导的ED50为0.22 mg·kg-1，CI为（0.19~0.26），ED95为0.32 mg·kg-1，CI为（0.28~0.51）。镇静成功组和镇静失败组麻醉诱导至插管时间分别为4.58（3.00，5.00）和4.63（3.25，5.75）min；手术时时间分别为13.63（7.00，17.00）和14.00（6.50，18.00）min；停药至拔管时间分别为17.84（7.00，21.00）和16.50（6.40，22.75）min；术后复苏停留时间分别为38.42（30.00，40.00）和41.56（22.10，49.25）min，镇静成功组的上述指标与镇静失败组比较，在统计学上差异均无统计学意义（均P>0.05）。镇静成功组的主要药物不良反应为嗜睡、低血压和低氧血症，镇静失败组为嗜睡和低血压。镇静成功组和镇静失败组的药物不良反应总发生率分别为22.22%（4例/18例）和17.65%（3例/17例），在统计学上差异无统计学意义（P>0.05）。
结论 瑞马唑仑注射液联合芬太尼注射液用于小儿全身麻醉置入喉罩的ED50为0.22 mg·kg-1，CI为（0.19~0.26）。
, authors=李茹, 金啸, authorsList=李茹, 金啸, authorCompany=null, correspAuthors=金啸, authorNote=
李茹（1983-），女，硕士研究生，主治医师，主要从事儿科麻醉方面的临床工作和研究工作
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李茹（1983-），女，硕士研究生，主治医师，主要从事儿科麻醉方面的临床工作和研究工作
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