ED50 of remifentanil for providing excellent intubating conditions when co-administered with a single standard dose of propofol without the use of muscle relaxants in children: dose-finding clinical trial

Ono, Andre Hideo; Moura, Thiago Rocha; Govêia, Cátia Sousa; Guimarães, Gabriel Magalhães Nunes; Ladeira, Luís Cláudio de Araújo; Silva, Helga Bezerra Gomes da

doi:10.1007/s00540-018-2502-z

Cited by 9 publications

(5 citation statements)

References 24 publications

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“…It is a reliable method for clinical research to determine effective doses. 7,8 In this study, the Dixon sequential method was used, and we found that the ED50 values for propofol co-administered with low-dose sufentanil at 0.2 μg/kg and 0.1 μg/kg for intravenous anaesthesia in hysteroscopic surgery were 1.651 mg/kg As an endoscopic surgical procedure, hysteroscopy has become an important technique to evaluate intrauterine pathology. Advancements in hysteroscopy technology have led to a shift from blind approaches to direct visualization in common outpatient procedures.…”

Section: Discussionmentioning

confidence: 85%

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ED50 of propofol in combination with low‐dose sufentanil for intravenous anaesthesia in hysteroscopy

Jiang¹,

Xiang²,

Song³

et al. 2019

Basic Clin Pharma Tox

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Objectives: Sufentanil has favourable pharmacodynamic and pharmacokinetic properties as an opioid, and it is usually co-administered with propofol as intravenous anaesthesia for hysteroscopic examination or therapeutic surgery. However, the optimal dosage of propofol when it is co-administered with low-dose sufentanil has not yet been established. This study was designed to find the median effective dose of propofol for intravenous anaesthesia when combined with low-dose sufentanil. Methods: Fifty-four patients were enrolled and randomized into two groups in this prospective study. Sufentanil 0.2 μg/kg (Group A) or 0.1 μg/kg (Group B) was given intravenously before speculum placement. The initial propofol dose was set at 2 mg/ kg and varied by 0.1 mg/kg according to the sequential allocation up-and-down rule designed by Dixon and Massey. Respiratory depression, duration of initial dose of propofol, total drug quantity administered and recovery time were recorded. Results: The ED50 of propofol was 1.651 mg/kg (95% CI, 1.561-1.722 mg/kg) in Group A and 1.991 mg/kg (95% CI, 1.902-2.081 mg/kg) in Group B. The ED95 of propofol was 1.827 mg/kg (95% CI, 1.746-2.236 mg/kg) in Group A and 2.153 mg/ kg (95% CI, 2.070-2.73 7 mg/kg) in Group B. The initial and total dosage of propofol in Group A were significantly lower than those in Group B, but the incidence of respiratory depression in Group A (26.67%) was significantly higher than that in Group B (4.17%). Conclusion:The ED50 values for propofol when co-administered with low-dose sufentanil for intravenous anaesthesia in hysteroscopy were 1.651 mg/kg (sufentanil 0.2 μg/kg) and 1.991 mg/kg (sufentanil 0.1 μg/kg). (www.chictr.org.cn, registration number: ChiCTR1900021224). K E Y W O R D Sdrug-drug interactions, hysteroscopy, median effective dose, propofol, sufentanil

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Section: Discussionmentioning

confidence: 85%

“…Its advantages include minimized sample size, use of concentrated test doses, efficiency and ease of implementation. It is a reliable method for clinical research to determine effective doses …”

Section: Discussionmentioning

confidence: 99%

ED50 of propofol in combination with low‐dose sufentanil for intravenous anaesthesia in hysteroscopy

Jiang¹,

Xiang²,

Song³

et al. 2019

Basic Clin Pharma Tox

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“…There are two methods of increasing or decreasing the dose gradient of the test drug that are more commonly used in sequential testing, one is the equal proportional increase or decrease method 17 and the other is the equal difference increase or decrease method. 18,19 Equivariate increases and decreases make it easier to control the dose increases and decreases, facilitate the calculation and dosing of the next patient, save trial time and reduce the difficulty of dosing, and also shorten the study period.…”

Section: Discussionmentioning

confidence: 99%

Median Effective Dose of Ciprofol Combined With Sufentanil for Inhibiting the Upper Gastrointestinal Endoscopic Placement Reaction in Elderly Patients

Xiong,

Xu,

Yang

et al. 2024

Dose-Response

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Objective Ciprofol is a new sedative anesthetic drug that can be used for gastrointestinal endoscopy and induction of general anesthesia, but the appropriate dosage for use in elderly patients has not been determined. Sufentanil is a commonly used opioid in clinical practice, and this study was designed to induce anesthesia in elderly patients using sufentanil in combination with ciprofol. However, the optimal dosage of ciprofol when it is co-administered with sufentanil has not yet been established. This study was designed to find the median effective dose (ED50) and 95% confidence interval (95% CI) of ciprofol for intravenous anesthesia when combined with sufentanil. Methods We studied 57 patients who were scheduled to undergo a diagnostic upper gastrointestinal endoscopy. According to age, it was divided into two groups: 65∼74 years old (group A) and over 75 years old (group B). Using the modified Dixon sequence test method, intravenous bolus of 0.1 μg/kg sufentanil was given 3 min before ciprofol is administered, the initial dose of ciprofol was 0.4 mg/kg, the upper gastrointestinal endoscopy was placed after reaching the depth of sedation, and vital signs and adverse events were recorded at each perioperative time point (T0-T7). Results In the group A, when combined with 0.1 μg/kg sufentanil, the ED50 of ciprofol to inhibiting responses to insertion of upper gastrointestinal endoscopy was 0.23 mg/kg, and the 95% CI was 0.09∼0.30 mg/kg; in the group B, the ED50 was 0.18 mg/kg, and the 95% CI was 0.13∼0.22 mg/kg. Conclusion The ED50 of ciprofol in combination with sufentanil (0.1 μg/kg) for upper gastrointestinal endoscopy in elderly patients: 0.23 mg/kg in group A and 0.18 mg/kg in group B.

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“…However, it should be considered that a higher dose of alfentanil (20 mcg/kg) and sevoflurane (8%) in infants resulted in profound hypotension 10 . Another option among opioids could be remifentanil, an ultra‐short‐acting opioid; however, this caused difficult positive pressure facial mask ventilation in 15% of children when evaluated 21 ; a situation where positive pressure ventilation with a mask is not possible is one that all anesthesiologists want to avoid during induction.…”

Section: Discussionmentioning

confidence: 99%

Tracheal intubation with or without a neuromuscular blocking agent for a short surgical procedure in children: Prospective, randomized, double‐blind trial

Park

Kim

Bae

et al. 2021

Pediatric Anesthesia

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Background: Although a neuromuscular blocking agent during induction of anesthesia is the standard of care in adults, some pediatric anesthesiologists remain concerned about their use for several reasons. Therefore, propofol and short-acting opioids with a moderate concentration of sevoflurane have been used as alternatives to a neuromuscular blocking agent.Aims: This study compared propofol, alfentanil, and rocuronium to determine the optimal anesthetic agent for intubation conditions as well as emergence in a short pediatric procedure. Methods:In this prospective, randomized, double-blind study, 114 pediatric patients, aged 1-9 years, were randomly assigned to one of three groups receiving either propofol 2 mg kg −1 (propofol group), alfentanil 14 mcg kg −1 (alfentanil group), or rocuronium 0.3 mg kg −1 (rocuronium group). The primary outcome was intubating conditions, which were evaluated 90 s after test drug administration. Vital signs were recorded during the intubation period. Complications during and after emergence, time to recovery, airway-related complications, and severity of emergence agitation were recorded.Results: Compared with the propofol group (60%), significantly more excellent intubating conditions were observed in the alfentanil group (97%, percent difference −37, 95% confidence interval (CI) −54.4-−21.0, p < .001) and the rocuronium group (87%, percent difference −27, 95% CI −46.5-−8.2, p = .041). Hemodynamic responses were different between the rocuronium and alfentanil groups, although the incidence of adverse events was not different among the three groups. The emergence duration was only statistically different between the rocuronium group [9.9 ± 3.2 min] and the propofol group [11.7 ± 2.2 min] (difference 95% CI 0.667-3.583, p = .001), while that of the alfentanil group [10.9 ± 2.4 min] was comparable with the other groups.Conclusions: Both 0.3 mg kg −1 rocuronium and 14 µg kg −1 alfentanil are superior adjuncts for tracheal intubation in children undergoing frenulectomy in comparison with 2 mg kg −1 propofol. Hemodynamic adverse events and recovery profiles were comparable among the three groups.

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ED50 of remifentanil for providing excellent intubating conditions when co-administered with a single standard dose of propofol without the use of muscle relaxants in children: dose-finding clinical trial

Abstract: NCT02454868.

Cited by 9 publications

References 24 publications

ED50 of propofol in combination with low‐dose sufentanil for intravenous anaesthesia in hysteroscopy

ED50 of propofol in combination with low‐dose sufentanil for intravenous anaesthesia in hysteroscopy

Median Effective Dose of Ciprofol Combined With Sufentanil for Inhibiting the Upper Gastrointestinal Endoscopic Placement Reaction in Elderly Patients

Tracheal intubation with or without a neuromuscular blocking agent for a short surgical procedure in children: Prospective, randomized, double‐blind trial

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