The Optimal Doses of Dexmedetomidine Combined with Propofol in Patients in Hysteroscopic Surgery: A Randomized Controlled Trial.

IF 5.1 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2025-09-16 eCollection Date: 2025-01-01 DOI:10.2147/DDDT.S544566

Hongchun Xu, Tong Peng, Dan Xie, Biqian Dong, Tiantian An, Fangjun Wang

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Abstract

Background: Dexmedetomidine has been reported to be utilized in conjunction with propofol during hysteroscopic surgery. However, both dexmedetomidine and propofol have benefits and side-effects, and the optimal doses of dexmedetomidine when utilized in combination with propofol during hysteroscopic surgery remain unestablished.

Methods: One hundred and fifty patients undergoing hysteroscopic surgery at the affiliated hospital of North Sichuan Medical College were randomly divided into five groups and administered dexmedetomidine at a dose of 0.4 µg/kg, 0.6 µg/kg, 0.8 µg/kg, or 1.0 µg/kg, or saline, prior to anesthesia induction. Before the surgery, propofol was administered via target-controlled infusion using a pump with the Marsh model. The EC₅₀ of propofol was determined using an up-and-down sequential method with an adjacent concentration gradient of 1.2 to prevent purposeful movements. Hemodynamic parameters and adverse events related to anesthesia were also evaluated. The duration of the procedure and recovery, the amount of propofol required, and the postoperative recovery characteristics were documented.

Results: The EC50 of propofol was significantly lower in the Dex 0.6, Dex 0.8, and Dex 1.0 groups compared to the S group (p<0.05). As the dose of dexmedetomidine increased, the demand for propofol gradually decreased (p<0.01), whereas the incidence of respiratory depression decreased (p<0.01). Nevertheless, the incidence of bradycardia slightly increased (p=0.02). No significant differences in the incidence of hypotension were observed among the five groups (p>0.05). The patients in the Dex1.0 groups had higher postoperative comfort scores than those in the S group. At both t1 and t2, Ramsay scores were higher in the Dex0.8 and Dex1.0 groups than in the S group (p<0.05). No significant differences were observed in the VAS scores among the five groups.

Conclusion: Dexmedetomidine 0.8 µg/kg offers an optimal balance between propofol-sparing effects, sedation quality, and manageable side effects for hysteroscopic surgery.

Trial registration: Date of registration: 24/05/2020, registration number: ChiCTR2000033220.

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右美托咪定联合异丙酚在宫腔镜手术患者中的最佳剂量：一项随机对照试验。

背景：据报道，右美托咪定在宫腔镜手术中与异丙酚联合使用。然而，右美托咪定和异丙酚都有益处和副作用，宫腔镜手术中右美托咪定与异丙酚联合使用的最佳剂量仍未确定。方法：选取川北医学院附属医院宫腔镜手术患者150例，随机分为5组，麻醉诱导前分别给予0.4、0.6、0.8、1.0 μ g/kg剂量的右美托咪定或生理盐水。在手术前，使用Marsh模型的泵通过靶控输注异丙酚。采用上下顺序法测定异丙酚的EC50，相邻浓度梯度为1.2，以防止有目的的移动。血流动力学参数和麻醉相关的不良事件也进行了评估。记录手术时间和恢复情况、丙泊酚用量以及术后恢复情况。结果：Dex 0.6、Dex 0.8、Dex 1.0组异丙酚EC50明显低于S组（pppp=0.02）。五组患者低血压发生率比较，差异无统计学意义（p < 0.05）。Dex1.0组患者术后舒适度评分高于S组。在t1和t2时，Dex0.8和Dex1.0组的Ramsay评分均高于S组(结论：0.8µg/kg右美托咪定在宫腔镜手术中具有异丙酚保留效果、镇静质量和可控制的副作用之间的最佳平衡。试验注册：注册日期：24/05/2020，注册号：ChiCTR2000033220。

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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.