Optimal Effect-Site Concentration of Propofol for Hemodynamic Stability During Intubation with Dexmedetomidine: A Randomized Controlled Study.

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2025-04-24 eCollection Date: 2025-01-01 DOI:10.2147/DDDT.S508736

Huayuan Gao, Junmei Wu, Youwen Chen, Chengyu Wang, Minmin Yao, Yan Yang, Changhong Miao, Chao Liang

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引用次数: 0

Abstract

Background: This study aimed to determine the 95% effective concentration (EC₉₅) of propofol via target-controlled infusion (TCI) for endotracheal intubation at three different doses of dexmedetomidine.

Methods: One hundred and eighty patients aged 18-60 and classified as American Society of Anesthesiologists (ASA) class I-II were enrolled to undergo general anesthesia. Patients were randomly assigned to one of the three groups (A, B, or C), receiving three different doses of dexmedetomidine (0.6, 0.8, or 1 μg/kg) infused over 10 min. Anesthesia was then induced with propofol TCI, followed by rocuronium. The biased coin design method was used to calculate the EC₉₅ of propofol for successful intubation. The primary outcome endpoint was the EC₉₅ of propofol for successful endotracheal intubation at each dexmedetomidine dose.

Results: Sixty patients in each group completed the trial. The time from propofol administration to intubation in group C (132.5 ± 10.7 s) was significantly shorter compared to group A (140.2 ± 14.4 s, P<0.0001) and group B (142.6 ± 13.2 s, P=0.0037). Both the EC₉₅ and the average total dose of propofol in group B [14.6 (10.8, 14.8) μg/mL and 3.6 ± 1.1 mg/kg] and C [12.7 (11.5, 12.8) μg/mL and 2.8 ± 1.0 mg/kg] were lower than those in group A [14.9 (4.5, 15.0) μg/mL and 3.8 ± 0.9 mg/kg] (P<0.001). The incidence of hypotension and bradycardia during induction was low in each group.

Conclusion: The EC₉₅ of propofol for endotracheal intubation across three different background doses of dexmedetomidine was determined. We suggest administering 1.0 μg/kg dexmedetomidine and then the EC₉₅ of propofol for successful endotracheal intubation was 12.7 μg/mL.

Registration: Chinese Clinical Trial Registry; Registration number: ChiCTR2400089952, URL:https://www.chictr.org.cn/showproj.html?proj=221236.

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异丙酚对右美托咪定插管期间血流动力学稳定性的最佳效位浓度：一项随机对照研究。

背景：本研究旨在通过靶控输注（TCI）测定三种不同剂量右美托咪定气管插管时异丙酚的95%有效浓度（EC95）。方法：180例年龄在18-60岁，被美国麻醉医师学会（ASA）分类为I-II级的患者接受全身麻醉。患者随机分为三组（A、B、C），分别给予三种不同剂量的右美托咪定（0.6、0.8或1 μg/kg），输注时间超过10分钟。然后用异丙酚TCI诱导麻醉，随后用罗库溴铵麻醉。采用偏置硬币设计法计算异丙酚成功插管的EC95。主要终点是异丙酚在每次右美托咪定剂量下气管插管成功的EC95。结果：每组60例患者完成试验。丙泊酚给药至插管时间C组（132.5±10.7 s）明显短于A组（140.2±14.4 s， PP=0.0037）。B组异丙酚EC95和平均总剂量[14.6 (10.8,14.8)μg/mL和3.6±1.1 mg/kg]和C组[12.7 (11.5,12.8)μg/mL和2.8±1.0 mg/kg]均低于A组[14.9 (4.5,15.0)μg/mL和3.8±0.9 mg/kg](结论：测定了3种不同背景剂量右美托咪定气管插管用异丙酚的EC95。我们建议先给予右美托咪定1.0 μg/kg，再给予异丙酚EC95为12.7 μg/mL气管插管成功。注册：中国临床试验注册中心；注册号：ChiCTR2400089952，网址：https://www.chictr.org.cn/showproj.html?proj=221236。

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.