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The effective dose of remimazolam in combination with sufentanil for sedation
during transvaginal oocyte retrieval: an up-and-down sequential allocation trial
#MMPMID41254500
Lu Y
; Duan G
; Fu J
; Luo F
; Wang B
; Lang J
BMC Anesthesiol
2025[Nov]; 25
(1
): 571
PMID41254500
show ga
BACKGROUND: The potential adverse effects of propofol on fertilization outcomes
have raised concerns among patients undergoing anesthesia for oocyte retrieval.
Remimazolam is a new type of ultra-short-acting benzodiazepine. This study aimed
to find the effective dose of remimazolam in combination with sufentanil for
sedation in oocyte retrieval. METHODS: Patients aged 20 to 45 years with a BMI of
18.5 to 27.9 kg/m² and ASA physical status I or II, undergoing transvaginal
oocyte retrieval, were recruited. All patients were administered intravenous
sufentanil at a dose of 0.1 µg/kg, followed by intravenous remimazolam after
2 min. The initial remimazolam dose was set at 0.2 mg/kg and adjusted by
0.02 mg/kg according to the modified Dixon sequential method. The primary
endpoint was successful sedation, defined as a Modified Observer?s Assessment of
Alertness/Sedation (MOAA/S) score???1 and an Intraoperative Movement Scale (IOMS)
score?2 within 5 min. Adverse events were recorded. The estimation of ED(50),
ED(90) and ED(95) with a 95% confidence interval (CI) was conducted by probit
regression. RESULTS: The ED(50), ED(90) and ED(95) of remimazolam for successful
sedation in combination with sufentanil induction were 0.205 mg/kg (95% CI
0.190?0.222), 0.232 mg/kg (95% CI 0.218?0.311) and 0.240 mg/kg (95% CI
0.223?0.339), respectively. There were three cases of hypoxemia, with no other
adverse events reported, including injection pain, hypotension, bradycardia,
dizziness, nausea, vomiting, or delayed emergence. CONCLUSIONS: In summary, when
combined with 0.1 µg/kg of sufentanil, the ED(50), ED(90) and ED(95) values of
remimazolam for effective sedation during transvaginal oocyte retrieval, were
0.205 mg/kg, 0.232 mg/kg and 0.240 mg/kg, respectively, with a low occurrence of
adverse events. TRIAL REGISTRATION: The study protocol was registered at
http://www.chictr.org.cn (registration number: ChiCTR2400082576 on 01/04/2024).