{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:48:53Z","timestamp":1774878533710,"version":"3.50.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T00:00:00Z","timestamp":1685404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Background and Purpose:<\/jats:bold> The prevalence of elderly patients prompts anesthesiologists to determine the optimal dose of medication due to the altered pharmacokinetics and pharmacodynamics of this population. The present study aimed to determine the 95% effective dose (ED<jats:sub>95<\/jats:sub>) of remimazolam tosylate in anesthesia induction to inhibit endotracheal intubation-related cardiovascular reaction in frail and non-frail senile patients.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A prospective sequential allocation dose-finding study of remimazolam tosylate was conducted on 80 elderly patients who received general anesthesia between May and June 2022\u00a0at the First Affiliated Hospital of Nanchang University. The initial dose was 0.3\u00a0mg\/kg. The blood pressure and heart rate fluctuations during intubation were either &amp;lt;20% (negative cardiovascular response) or \u226520% (positive cardiovascular response). If positive, the dose of the next patient was increased by 0.02\u00a0mg\/kg, while if negative, it was reduced by 0.02\u00a0mg\/kg according to the 95:5 biased coin design (BCD). The ED<jats:sub>95<\/jats:sub> and 95% confidence intervals (CIs) were determined using R-Foundation isotonic regression and bootstrapping methods.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The ED<jats:sub>95<\/jats:sub> of remimazolam tosylate to inhibit the response during tracheal intubation was 0.297\u00a0mg\/kg (95% CI: 0.231\u20130.451\u00a0mg\/kg) and 0.331\u00a0mg\/kg (95% CI: 0.272\u20130.472\u00a0mg\/kg) in frail and non-frail senile patients, respectively.<\/jats:p><jats:p><jats:bold>Conculation and Implications:<\/jats:bold> The CI of the two groups overlap, and no difference was detected in the ED<jats:sub>95<\/jats:sub> of remimazolam tosylate in inhibiting endotracheal intubation-related cardiovascular response in frail and non-frail senile patients. These results suggested that remimazolam tosylate is an optimal anesthesia inducer for all elderly patients.<\/jats:p><jats:p><jats:bold>Clinical Trial Registration:<\/jats:bold><jats:ext-link>https:\/\/www.chictr.org.cn<\/jats:ext-link>, identifier ChiCTR2200055709.<\/jats:p>","DOI":"10.3389\/fphar.2023.1136003","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T13:18:52Z","timestamp":1685539132000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Determination of the 95% effective dose of remimazolam tosylate in anesthesia induction inhibits endotracheal intubation response in senile patients"],"prefix":"10.3389","volume":"14","author":[{"given":"Liangchao","family":"Qu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ru","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianyuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dingde","family":"Long","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengyu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liqin","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1213\/ANE.0000000000000548","article-title":"A Phase IIa, randomized, double-blind study of remimazolam (CNS 7056) versus midazolam for sedation in upper gastrointestinal endoscopy","volume":"120","author":"Borkett","year":"2015","journal-title":"Anesth. analgesia"},{"key":"B2","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1016\/j.spinee.2021.01.028","article-title":"Frailty adversely affects outcomes of patients undergoing spine surgery: A systematic review","volume":"21","author":"Chan","year":"2021","journal-title":"Spine J."},{"key":"B3","first-page":"4594","article-title":"The efficacy and safety of remimazolam tosylate versus propofol in patients undergoing colonoscopy: A multicentered, randomized, positive-controlled, phase III clinical trial","volume":"12","author":"Chen","year":"2020","journal-title":"Am. 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