联合布托啡诺时环泊酚在老年患者无痛胃镜检查中的有效剂量及安全性

Effective dose and safety of ciprofol in combination with butorphanol for painless gastroscopy in elderly patients

目的探讨联合布托啡诺时环泊酚用于老年患者无痛胃镜检查的半数有效剂量(ED_(50))和95%有效剂量(ED_(95))。方法选择择期行胃镜检查的老年患者27例,均给予静脉注射布托啡诺5μg/kg至少30 s,3 min后静脉注射环泊酚至少30 s;当睫毛反射消失或者警觉/镇静评分(MOAA/S)<1分时进行胃镜检查。环泊酚最初剂量设为0.2 mg/kg,采用改良序贯等差法测定;若胃镜置入发生阳性反应,则下例患者剂量增加1级,反之则剂量减少1级,相邻剂量梯度为0.05 mg/kg。将胃镜置入发生阳性反应定义为:胃镜进入咽喉部时发生呛咳、吞咽或肢体动作。整个研究过程中,若环泊酚剂量调整有7次折返,试验终止。计算复合布托啡诺时环泊酚对无痛胃镜检查的ED_(50)、ED_(95)和相应的95%可信区间(95%CI)。结果复合布托啡诺时,环泊酚对老年患者无痛胃镜检查的ED_(50)为0.253 mg/kg(95%CI:0.219~0.290),ED_(95)为0.328 mg/kg(95%CI:0.290~0.521)。结论复合布托啡诺时,环泊酚用于老年患者无痛胃镜检查ED_(50)为0.253 mg/kg,ED_(95)为0.328 mg/kg。

Objective To investigate the median effective dose(ED_(50))and 95%effective dose(ED_(95))of ciprofol in combination with butorphanol for painless gastroscopy in elderly patients.Methods A total of 27 elderly patients with selective gastroscopy were conducted with intravenous induction of 5μg/kg butorphanol for at least 30 seconds,and 3 minutes later,they were administered intravenously with ciprofol for at least 30 seconds;gastroscopy was performed when the eyelash reflex disappeared or the Modified Observer's Assessment of Alertness/Sedation(MOAA/S)score was less than one point.The initial dose of ciprofol was set as 0.2 mg/kg,and the modified sequential allocation method was used;if there was a positive response during the insertion of the gastroscope,the dose for the next patient would increase by one level,and vice versa,the dose would decrease by one level,with an adjacent dose concentration gradient of 0.05 mg/kg.A positive response to gastroscope insertion was defined as coughing,swallowing,or limb movements when the gastroscope entered the throat.The study was terminated after 7 reversals in ciprofol dose adjustments.ED_(50),ED_(95),and corresponding 95%confidence intervals(95%CI)of ciprofol combined with butorphanol for painless gastroscopy were calculated.Results When combined with butorphanol,the ED_(50) of ciprofol for painless gastroscopy in elderly patients was 0.253 mg/kg(95%CI,0.219 to 0.290),and the ED_(95) was 0.328 mg/kg(95%CI,0.290 to 0.521).Conclusion When combined with butorphanol,the ED_(50) of ciprofol for painless gastroscopy in elderly patients is 0.253 mg/kg,and the ED_(95) is 0.328 mg/kg.