A successful premedication score is not a general-anesthesia endpoint.
A small preschool study used sequential dose assignment and statistical modeling to estimate intranasal remimazolam doses for pre-induction sedation. Success was defined using a clinical scale over a specified period.
The study included twenty-nine preschool children. It used the University of Michigan Sedation Scale for pre-induction sedation, rather than successful surgery without additional anesthesia. Among positive responders, all reached the target within nine minutes. Sequential estimates of a high-response dose remained uncertain. These timing and scoring details prevent the result from being mistaken for an anesthetic induction threshold applicable to other populations.
The estimates depend on the chosen response threshold, age range, formulation and observation window. An ED95 is a population estimate with uncertainty, not a guarantee for the next child or proof of safety at other depths of sedation.
Name the target state before applying the result. Calm separation or mild sedation cannot be treated as equivalent to immobility during a painful procedure. The study does not establish a universal intranasal regimen or predict a particular child’s response under different co-exposures.
Source: PMC10987844, supplied full-text paper. Findings are paraphrased; forensic implications are an interpretation.
Related: Pediatric Sedation Z-Scores Were Relative Burden Measures Rather Than Dose Equivalents.