# The ED50 and ED95 of remimazolam tosilate to inhibit the gastroscopy reaction in elderly patients of varying ages: an up-and-down sequential allocation trial

## TL;DR

This study finds the effective doses of remimazolam tosilate for sedation during gastroscopy in two age groups of elderly patients.

## Contribution

The study determines the ED50 and ED95 of remimazolam tosilate for elderly patients in two distinct age groups.

## Key findings

- The ED50 for Group A (65–74 years) was 0.175 mg/kg, higher than Group B (75–89 years) at 0.163 mg/kg.
- The ED95 for Group A was 0.199 mg/kg and for Group B was 0.188 mg/kg.
- RT is a safe and effective sedative for elderly patients undergoing gastroscopy.

## Abstract

Although remimazolam tosilate (RT) has demonstrated efficacy in elderly gastroscopy, its optimum dose for gastroscopy in elderly patients of varying ages is still unclear. The study aimed to determine the median effective dose (ED50) and 95% effective dose (ED95) of RT to inhibit the gastroscopy reaction in patients aged 65–74 years and 75–89 years.

Sixty-one elderly patients were randomized into two groups: Group A (65–74 years, n = 31) and Group B (75–89 years, n = 30). Three minutes after the recruited subjects received 0.1 μg/kg of sufentanil, RT was administered intravenously at an initial dose of 0.15 mg/kg with 0.01 mg/kg step size according to the modified Dixon’s up-and-down method (UDM). This continued until nine crossover midpoints “positive–negative” were observed.

The ED50 of RT calculated by the modified UDM for inhibiting the gastroscopy reaction in Group A (0.175 (95% confidence interval, CI, 0.166–0.183) mg/kg) was higher than that in Group B (0.163 (95% CI, 0.156–0.169) mg/kg) (p = 0.03). The ED95 estimated by probit regression analysis was 0.199 (95% CI, 0.186–0.244) mg/kg in Group A and 0.188 (95% CI, 0.175–0.232) mg/kg in Group B.

RT is a relatively safe sedative hypnotic that can provide a suitable sedative effect for elderly patients undergoing a gastroscopy.

http://www.chictr.org.cn, identifier ChiCTR2200062842.