Why did the previous patient’s response determine the next remimazolam dose in a trial?
The trial used a sequential dose rule
In a study during surgical abortion, researchers estimated the remimazolam dose associated with preventing movement in 90% of patients under a protocol that also used remifentanil. When a participant moved, the next participant’s dose increased by 0.05 mg/kg. When a participant did not move, a computer-generated allocation list determined whether the next dose stayed the same or dropped by one step.
The study estimated a point on a response curve
This biased-coin design steers observations toward the dose region associated with the target response rate. The authors estimated an ED90 of 0.615 mg/kg, with a reported 95% confidence interval of 0.398 to 0.629 mg/kg. That estimate concerns a specified endpoint under the trial conditions. It does not establish how an individual would respond at the same dose.
What to compare in an anesthesia record
Identify the procedure, dose timing, accompanying medicines and actual response. The endpoint was observable movement during the procedure. A dose-finding estimate for that endpoint cannot be carried over directly to recall, respiratory events or sedation for a different procedure.
Source paper
Read the study at PubMed Central (PMC12318863).
