Incidence and Risk Factors for Hypoxia in Deep Sedation of Propofol for Artificial Abortion Patients

Fang, Yiling; Xu, Yaru; Cao, Silu; Sun, Xiaoru; Zhang, Hui; Jing, Qi; Liang, Tian; Li, Cheng

doi:10.3389/fmed.2022.763275

Cited by 6 publications

(7 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Using the centered As a classic sedative in anesthesia for outpatient surgery, propofol has the strengths of fast onset time, profound sedative effect, and short duration. However, it produces significant respiratory and circulatory depression, increasing the risk for adverse events like hypoxemia and hypotension (15,16). When used for procedural sedation, the sedative efficiency of RMZ was less than that of propofol as a novel IV sedative drug (17,18).…”

Section: Discussionmentioning

confidence: 99%

ED50 of remimazolam combined with different doses butorphanol for first trimester artificial abortion

Chen,

Li,

et al. 2024

Front. Med.

View full text Add to dashboard Cite

IntroductionRemimazolam (RMZ) is a novel intravenous sedative drug of ultra-short benzodiazepine. The optimal dose of RMZ plus butorphanol for sedation during first trimester artificial abortion is unknown. Therefore, the present study aimed to evaluate the median effective dose (ED50) of RMZ combined with different doses of butorphanol on the sedative effect for first-trimester artificial abortion.MethodsSixty-one female patients were randomly assigned to Group B10 (31 patients) and Group B15 (30 patients). RMZ was administered 5 min after IV butorphanol at doses of 10 μg/kg (Group B10) and 15 μg/kg (Group B15). Cervical dilatation at the time of using a cervical dilating rod, if the patient has body movement and affects the gynecologist’s operation, we define it as “Ineffective.” Therefore, the dose of RMZ was increased in the next patient. Otherwise, it was defined as “Effective,” and the dose of RMZ was reduced in the next patient. According to the pre-experiment, the first dose of RMZ in the first patient was 0.35 mg/kg, and the adjacent geometric dose ratio was 0.9. The centered isotonic regression was performed to determine the ED50 of RMZ. The total RMZ dose administered, recovery time, and anesthesia-related adverse events were all recorded.ResultsThe ED50 (90% CI) of RMZ was 0.263 (0.215–0.310) mg/kg in Group B10, and 0.224 (0.191–0.261) mg/kg in Group B15, respectively. The recovery time in Group B10 was significantly shorter than in Group B15 (9.8 ± 2.3 vs. 12.5 ± 3.6 min, p ≤ 0.001). There was no significant difference in the incidence rate of all anesthesia-related adverse events between the two groups (p > 0.05).ConclusionThe ED50 of RMZ combined with a 10 μg/kg or 15 μg/kg dose of butorphanol was 0.263 and 0.224 mg/kg during painless first trimester artificial abortion. However, RMZ combined with a 10 μg/kg dose of butorphanol seems to have a shorter recovery time.Clinical trial registrationhttps://www.chictr.org.cn/bin/project/edit?pid=166623.

show abstract

Section: Discussionmentioning

confidence: 99%

ED50 of remimazolam combined with different doses butorphanol for first trimester artificial abortion

Chen,

Li,

et al. 2024

Front. Med.

View full text Add to dashboard Cite

show abstract

“…Painless artificial abortion is one of the most common outpatient surgeries under procedural sedation, and most patients receive propofol. However, its clinical application is limited by injection-site pain, respiratory depression, and hemodynamic instability ( 18 – 20 ). Our research results also exhibited that HR, MAP, and SpO 2 declined after intravenous propofol administration.…”

Section: Discussionmentioning

confidence: 99%

The median effective dose of propofol combined with butorphanol during artificial abortion: a randomized controlled trial

Zheng,

Huang,

Mai

et al. 2023

Front. Med.

View full text Add to dashboard Cite

ObjectivePropofol-opioids are the most common drug combination and can reduce the dose of propofol and the incidence of adverse events in painless artificial abortion. We hypothesized that butorphanol may reduce the median effective dose (ED50) of propofol, propofol injection pain, and postoperative uterine contraction pain.MethodsThis was a randomized, double-blind, controlled study. A total of 54 female patients, who had ASA I or II, aged 18–49 years, undergoing painless artificial abortion, were randomly assigned into two groups, namely, Group P (propofol) and Group PB (propofol plus 10 μg/kg butorphanol). According to the pre-experiment, the initial dose of propofol for the P and PB groups was 3 and 2.5 mg/kg, respectively, with a dose gradient of 0.25 mg/kg. The ED50 of propofol was analyzed using probit regression analysis. The total propofol dose consumed, recovery time, and anesthesia-related adverse events were also recorded.ResultsThere were 25 and 29 patients in the P and PB groups, respectively. The ED50 (95% CI) of propofol for artificial abortion were 2.477 (2.186–2.737) and 1.555 (1.173–1.846) mg/kg in the P and PB groups, respectively. The total propofol dose consumed was (150.7 ± 21.7) mg and (110.4 ± 28.2) mg in the P and PB groups, respectively (P < 0.001). Compared with the P group, injection-site pain (76 vs. 20.7%) and uterine contraction pain (72 vs. 6.9%) in the PB group had a significant decrease (P < 0.001).ConclusionCombination of propofol with 10 μg/kg butorphanol reduced the ED50 of propofol and decreased the incidence of propofol injection-site pain and postoperative uterine contraction pain during painless artificial abortion compared with propofol alone.Clinical trial registrationhttps://www.chictr.org.cn/showproj.html?proj=166610, identifier: ChiCTR2200059795.

show abstract

“…Current surgical abortion with general anesthetic includes the administration of propofol, which has a rapid onset of action (15–40 s) and a short half‐life (30–60 min) 6,7 . However, adverse events, especially respiratory depression, hypoxia, hypotension, and pain at the injection site, have long been recorded in deep sedation of propofol, in a dose‐dependent manner 8–10 . Remimazolam, a new ester‐based benzodiazepine, is quickly metabolized into inactive metabolites by tissue esterases 11,12 .…”

Section: Introductionmentioning

confidence: 99%

“… 6 , 7 However, adverse events, especially respiratory depression, hypoxia, hypotension, and pain at the injection site, have long been recorded in deep sedation of propofol, in a dose‐dependent manner. 8 , 9 , 10 Remimazolam, a new ester‐based benzodiazepine, is quickly metabolized into inactive metabolites by tissue esterases. 11 , 12 It increases the activity of γ‐subunit‐containing GABAA receptors, which starts cell membrane hyperpolarization and inhibits neural activity by increasing chloride in‐flux.…”

Section: Introductionmentioning

confidence: 99%

Remimazolam versus propofol in combination with esketamine for surgical abortion: A double‐blind randomized controlled trial

Yue¹,

Ma²,

Li³

et al. 2023

Clinical Translational Sci

View full text Add to dashboard Cite

Remimazolam is a new benzodiazepine with a short half‐life, good efficacy, and safety profiles in general anesthesia. Combining esketamine with propofol (P + E) could reduce propofol consumption and injection pain. It is, however, unclear if a low dose of remimazolam co‐administrated with esketamine (R + E) is comparable to the increasingly used P + E for surgical abortion with general anesthetic. We conducted a double‐blind randomized controlled trial to compare the efficacy and safety of R + E and P + E. Two hundred patients scheduled for a surgical abortion were randomized to receive remimazolam 0.3 mg/kg plus esketamine 0.3 mg/kg (R + E), and propofol 2 mg/kg plus esketamine 0.3 mg/kg (P + E). Sedative effectiveness was evaluated by measuring the time to lose consciousness (LOC), recovery time, and successful sedation rate. Safety was assessed by hemodynamics and adverse events during and postoperation. The time to LOC and recovery time in R + E was 5 s shorter and 1 min longer than that in P + E, respectively (both p < 0.001). Success sedation rate did not differ between groups (p = 0.73). Bradycardia incidence and injection site pain were less frequent in the R + E group than that in the P + E group. More rash was observed in the R + E group compared with the P + E group (32% vs. 5%, p < 0.001), but all were mild (only chest rash) and resolved subsequently. Low dose of remimazolam when combined with esketamine has favorable profiles with rapid onset and recovery, but mild hemodynamic side effects and adverse events. It can be used as an alternative for surgical abortion with general anesthetic.

show abstract

Incidence and Risk Factors for Hypoxia in Deep Sedation of Propofol for Artificial Abortion Patients

Cited by 6 publications

References 47 publications

ED50 of remimazolam combined with different doses butorphanol for first trimester artificial abortion

ED50 of remimazolam combined with different doses butorphanol for first trimester artificial abortion

The median effective dose of propofol combined with butorphanol during artificial abortion: a randomized controlled trial

Remimazolam versus propofol in combination with esketamine for surgical abortion: A double‐blind randomized controlled trial

Contact Info

Product

Resources

About