Association of obesity with ropivacaine and sufentanil EC50 in labor analgesia: a single-center prospective study.

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2025-01-08 DOI:10.1007/s00228-024-03800-8

Zunyi Liu, Xuelan Zhou, Jiang Zhu

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引用次数: 0

Abstract

Objective: In part I, measure the EC50 of sufentanil in obese and non-obese parturients combined with 0.1% ropivacaine and compare the differences. Similarly, in part II, measure the EC50 of ropivacaine in obese and non-obese parturients combined with 0.5 µg/ml sufentanil and compare the differences.

Methods: This study comprises two parts, with an initial intention to enroll 120 full-term primiparous women who underwent vaginal delivery and sought epidural analgesia. Each part includes an obese group (OA group, Obese Adults, defined as prepartum BMI≥29 kg/m²) and a non-obese group (CON group, Control group, defined as 18.52), with 30 participants in each. Both parts, for both obese and non-obese women, utilized an initial concentration of 0.1% ropivacaine with 0.5 µg /ml sufentanil. The initial concentration of sufentanil is 0.5 µg/ml. When the NRS score is ≤3 within 30min after analgesia, it is considered effective analgesia, and the concentration of sufentanil in the next parturients decreases by 0.05 µg/ml. Otherwise, the concentration of sufentanil in the next parturient will increase by 0.05 µg/ml. The second part uses the same method to measure the EC50 of ropivacaine (increase or decrease by 0.01%) in the OA group and CON group combined with 0.5 µg/ml sufentanil, with 30 participants in each group. EC50 measurements were performed through up-and-down sequential allocation, with effective analgesia defined as an NRS score ≤3, 30 min post-analgesia.

Results: In part I, the EC50 of epidural sufentanil in the OA group was 0.090 µg/ml (95% CI, 0.061~0.115µg/ml), and in the CON group, it was 0.170µg/ml (95% CI, 0.117~0.219µg/ml). In part II, the EC50 of epidural ropivacaine in the OA group was 0.048% (95% CI, 0.041~0.053%), and in the CON group, it was 0.070% (95% CI, 0.064~0.075%). The secondary outcomes in both parts of the study showed no statistically significant differences.

Conclusion: Obese parturients exhibited significantly lower EC50 values for ropivacaine and sufentanil compared to non-obese parturients. Lower concentrations of both agents can be considered for labor analgesia in obese parturients.

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妊娠镇痛中肥胖与罗哌卡因和舒芬太尼EC50的关系：一项单中心前瞻性研究。

目的：第一部分测量舒芬太尼在肥胖和非肥胖孕妇联合0.1%罗哌卡因的EC50，并比较其差异。同样，在第二部分中，测量肥胖和非肥胖孕妇罗哌卡因与0.5µg/ml舒芬太尼联合使用的EC50，并比较差异。方法：本研究包括两个部分，最初的目的是招募120名接受阴道分娩并寻求硬膜外镇痛的足月初产妇。每个部分包括肥胖组（OA组，obese Adults，定义为术前BMI≥29 kg/m2）和非肥胖组（CON组，Control group，定义为18.52），每组30人。对于肥胖和非肥胖女性，使用0.1%罗哌卡因和0.5µg /ml舒芬太尼的初始浓度。舒芬太尼初始浓度为0.5µg/ml。当镇痛后30min内NRS评分≤3分时，视为镇痛有效，下一产妇舒芬太尼浓度降低0.05µg/ml。否则，下一胎舒芬太尼浓度将增加0.05µg/ml。第二部分采用相同的方法测量OA组和CON组联合0.5µg/ml舒芬太尼的罗哌卡因EC50（升高或降低0.01%），每组30人。通过上下顺序分配进行EC50测量，有效镇痛定义为NRS评分≤3,30 min。结果：第一部分中，OA组舒芬太尼硬膜外EC50为0.090µg/ml (95% CI, 0.061~0.115µg/ml)， CON组EC50为0.170µg/ml （95% CI, 0.117~0.219µg/ml）。第二部分，OA组硬膜外罗哌卡因EC50为0.048% (95% CI, 0.041~0.053%)， CON组EC50为0.070% （95% CI, 0.064~0.075%）。两部分研究的次要结果没有统计学上的显著差异。结论：肥胖孕妇对罗哌卡因和舒芬太尼的EC50值明显低于非肥胖孕妇。低浓度的这两种药物可以考虑用于肥胖产妇的分娩镇痛。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.