Effective doses of remimazolam and esketamine combined with remifentanil for endotracheal intubation without muscle relaxants in pediatric patients.
Frontiers in pharmacology January 1, 2025 Jinming Chen, Ying Mai, Xiaolei Cheng et al. 5 citations
In children aged 3 to 6 undergoing endotracheal intubation without muscle relaxants, the combination of remimazolam and esketamine with a fixed dose of remifentanil (2.5 μg/kg) provided safe and effective intubation conditions while maintaining hemodynamic stability. Using Dixon's up-and-down method, the 50% effective dose (ED50) for esketamine was 0.74 mg/kg and the 95% effective dose (ED95) was 0.97 mg/kg. For remimazolam, the ED50 was 0.39 mg/kg and the ED95 was 0.56 mg/kg. No significant adverse events were observed, and heart rate and blood pressure remained stable during induction. These doses serve as initial references for pediatric intubation without muscle relaxants.