Determination of the median effective dose of sufentanil combined with remimazolam in inhibiting tracheal intubation response

Abstract To determine the median effective dose (ED50) and 95% effective dose (ED95) of sufentanil combined with remimazolam for inhibiting the tracheal intubation response in patients undergoing general anesthesia and to evaluate the hemodynamic stability and adverse events associated with this dru...

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Main Authors: Lin Feng, Liang Zeng, Xuelei Zhou, Yiping Guo, Xianchun Liu, Longyi Zhang, Ting Zhang, Linji Li, Li Zhao
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-08907-1
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author Lin Feng
Liang Zeng
Xuelei Zhou
Yiping Guo
Xianchun Liu
Longyi Zhang
Ting Zhang
Linji Li
Li Zhao
author_facet Lin Feng
Liang Zeng
Xuelei Zhou
Yiping Guo
Xianchun Liu
Longyi Zhang
Ting Zhang
Linji Li
Li Zhao
author_sort Lin Feng
collection DOAJ
description Abstract To determine the median effective dose (ED50) and 95% effective dose (ED95) of sufentanil combined with remimazolam for inhibiting the tracheal intubation response in patients undergoing general anesthesia and to evaluate the hemodynamic stability and adverse events associated with this drug combination. This prospective dose-finding study used Dixon’s up-and-down sequential allocation method. A total of 36 patients undergoing general anesthesia surgery between April 2024 and June 2024 were enrolled. Patients were administered remimazolam for induction, followed by sufentanil at an initial dose of 0.4 µg/kg, with subsequent doses adjusted based on the presence or absence of an intubation response. The primary outcome was the ED50 of sufentanil combined with remimazolam, and the secondary outcomes included patient baseline characteristics, hemodynamic parameters, and adverse events. The ED50 and ED95 of sufentanil for inhibiting tracheal intubation response were 0.374 µg/kg (95% CI: 0.342–0.402 µg/kg) and 0.436 µg/kg (95% CI: 0.406–0.586 µg/kg), respectively. Patients with a positive tracheal intubation response had significantly higher heart rates and mean arterial pressures and a higher incidence of hypertension. The ED50 and ED95 of sufentanil combined with remimazolam for inhibiting the tracheal intubation response in patients undergoing general anesthesia were 0.374 and 0.436 µg/kg, respectively. This study provides valuable insights into the dosing of these drugs for effective anesthesia induction and hemodynamic control during tracheal intubation.
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spelling doaj-art-eafe87c33b2847b18f5adb02a21177f92025-08-20T03:03:32ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-08907-1Determination of the median effective dose of sufentanil combined with remimazolam in inhibiting tracheal intubation responseLin Feng0Liang Zeng1Xuelei Zhou2Yiping Guo3Xianchun Liu4Longyi Zhang5Ting Zhang6Linji Li7Li Zhao8Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central HospitalDepartment of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central HospitalDepartment of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central HospitalNanchong Center for Disease Control and PreventionDepartment of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central HospitalDepartment of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central HospitalDepartment of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central HospitalDepartment of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central HospitalDepartment of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central HospitalAbstract To determine the median effective dose (ED50) and 95% effective dose (ED95) of sufentanil combined with remimazolam for inhibiting the tracheal intubation response in patients undergoing general anesthesia and to evaluate the hemodynamic stability and adverse events associated with this drug combination. This prospective dose-finding study used Dixon’s up-and-down sequential allocation method. A total of 36 patients undergoing general anesthesia surgery between April 2024 and June 2024 were enrolled. Patients were administered remimazolam for induction, followed by sufentanil at an initial dose of 0.4 µg/kg, with subsequent doses adjusted based on the presence or absence of an intubation response. The primary outcome was the ED50 of sufentanil combined with remimazolam, and the secondary outcomes included patient baseline characteristics, hemodynamic parameters, and adverse events. The ED50 and ED95 of sufentanil for inhibiting tracheal intubation response were 0.374 µg/kg (95% CI: 0.342–0.402 µg/kg) and 0.436 µg/kg (95% CI: 0.406–0.586 µg/kg), respectively. Patients with a positive tracheal intubation response had significantly higher heart rates and mean arterial pressures and a higher incidence of hypertension. The ED50 and ED95 of sufentanil combined with remimazolam for inhibiting the tracheal intubation response in patients undergoing general anesthesia were 0.374 and 0.436 µg/kg, respectively. This study provides valuable insights into the dosing of these drugs for effective anesthesia induction and hemodynamic control during tracheal intubation.https://doi.org/10.1038/s41598-025-08907-1SufentanilRemimazolamTracheal intubationMedian effective dose (ED50)Anesthesia induction
spellingShingle Lin Feng
Liang Zeng
Xuelei Zhou
Yiping Guo
Xianchun Liu
Longyi Zhang
Ting Zhang
Linji Li
Li Zhao
Determination of the median effective dose of sufentanil combined with remimazolam in inhibiting tracheal intubation response
Scientific Reports
Sufentanil
Remimazolam
Tracheal intubation
Median effective dose (ED50)
Anesthesia induction
title Determination of the median effective dose of sufentanil combined with remimazolam in inhibiting tracheal intubation response
title_full Determination of the median effective dose of sufentanil combined with remimazolam in inhibiting tracheal intubation response
title_fullStr Determination of the median effective dose of sufentanil combined with remimazolam in inhibiting tracheal intubation response
title_full_unstemmed Determination of the median effective dose of sufentanil combined with remimazolam in inhibiting tracheal intubation response
title_short Determination of the median effective dose of sufentanil combined with remimazolam in inhibiting tracheal intubation response
title_sort determination of the median effective dose of sufentanil combined with remimazolam in inhibiting tracheal intubation response
topic Sufentanil
Remimazolam
Tracheal intubation
Median effective dose (ED50)
Anesthesia induction
url https://doi.org/10.1038/s41598-025-08907-1
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