Min Zhang, Yi Liu, Jing Cao, Mengjie Liu, Xiaojun Gao, Na Guo, Chuansong Wei, Ye Zhu, Yongtao Sun, Jianbo Wu
{"title":"羟考酮治疗不同年龄胸腔镜肺手术伴肋间神经阻滞术后急性疼痛的中位有效剂量：一项剂量发现研究方案。","authors":"Min Zhang, Yi Liu, Jing Cao, Mengjie Liu, Xiaojun Gao, Na Guo, Chuansong Wei, Ye Zhu, Yongtao Sun, Jianbo Wu","doi":"10.1186/s12871-025-03198-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Oxycodone is an effective drug for controlling acute postoperative pain (APP), especially visceral pain. However, the effective dose needed for controlling APP depends on the surgical method and the patient age. Therefore, through use of the Dixon up-and-down method, this study investigated the median effective dose (ED<sub>50</sub>) of oxycodone that could be combined with intercostal nerve block (INB) to effectively control APP after thoracoscopic pulmonary surgery in patients of different ages.</p><p><strong>Methods: </strong>This is a prospective, interventional, dose-finding study. Patients undergoing thoracoscopic lobar and sublobar resections under general anaesthesia will be selected and divided into 4 groups according to age and surgical method: the elderly lobectomy group (aged ≥ 65 years), the nonelderly lobectomy group (aged < 65 years), the elderly sublobar resection group (aged ≥ 65 years), and the nonelderly sublobar resection group (aged < 65 years). The study will be performed simultaneously in four experimental groups via the Dixon up-and-down method. The initial dose for the first patient in each group will be set to 0.1 mg/kg; the dose for the next patient will be determined by the response of the previous patient. The primary outcome is the ED<sub>50</sub> of oxycodone.</p><p><strong>Discussion: </strong>The results of this study are expected to provide an effective strategy for the management of APP following thoracoscopic pulmonary surgery and specifically to offer more accurate dose guidance for the use of oxycodone in older patients. This will not only improve the development of individualized pain management plans but also optimize the patient's postoperative recovery, reduce unnecessary drug side effects, and increase the overall comfort and quality of life of patients.</p><p><strong>Trial registration: </strong>This study was registered on clinicaltrials.gov (NCT06534801) on August 1, 2024.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"323"},"PeriodicalIF":2.3000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210816/pdf/","citationCount":"0","resultStr":"{\"title\":\"The median effective dose of oxycodone for acute postoperative pain after thoracoscopic pulmonary surgery with intercostal nerve blockin in patients of different ages: a dose-finding study protocol.\",\"authors\":\"Min Zhang, Yi Liu, Jing Cao, Mengjie Liu, Xiaojun Gao, Na Guo, Chuansong Wei, Ye Zhu, Yongtao Sun, Jianbo Wu\",\"doi\":\"10.1186/s12871-025-03198-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Oxycodone is an effective drug for controlling acute postoperative pain (APP), especially visceral pain. However, the effective dose needed for controlling APP depends on the surgical method and the patient age. Therefore, through use of the Dixon up-and-down method, this study investigated the median effective dose (ED<sub>50</sub>) of oxycodone that could be combined with intercostal nerve block (INB) to effectively control APP after thoracoscopic pulmonary surgery in patients of different ages.</p><p><strong>Methods: </strong>This is a prospective, interventional, dose-finding study. Patients undergoing thoracoscopic lobar and sublobar resections under general anaesthesia will be selected and divided into 4 groups according to age and surgical method: the elderly lobectomy group (aged ≥ 65 years), the nonelderly lobectomy group (aged < 65 years), the elderly sublobar resection group (aged ≥ 65 years), and the nonelderly sublobar resection group (aged < 65 years). The study will be performed simultaneously in four experimental groups via the Dixon up-and-down method. The initial dose for the first patient in each group will be set to 0.1 mg/kg; the dose for the next patient will be determined by the response of the previous patient. The primary outcome is the ED<sub>50</sub> of oxycodone.</p><p><strong>Discussion: </strong>The results of this study are expected to provide an effective strategy for the management of APP following thoracoscopic pulmonary surgery and specifically to offer more accurate dose guidance for the use of oxycodone in older patients. This will not only improve the development of individualized pain management plans but also optimize the patient's postoperative recovery, reduce unnecessary drug side effects, and increase the overall comfort and quality of life of patients.</p><p><strong>Trial registration: </strong>This study was registered on clinicaltrials.gov (NCT06534801) on August 1, 2024.</p>\",\"PeriodicalId\":9190,\"journal\":{\"name\":\"BMC Anesthesiology\",\"volume\":\"25 1\",\"pages\":\"323\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210816/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Anesthesiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12871-025-03198-5\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Anesthesiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12871-025-03198-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
The median effective dose of oxycodone for acute postoperative pain after thoracoscopic pulmonary surgery with intercostal nerve blockin in patients of different ages: a dose-finding study protocol.
Background: Oxycodone is an effective drug for controlling acute postoperative pain (APP), especially visceral pain. However, the effective dose needed for controlling APP depends on the surgical method and the patient age. Therefore, through use of the Dixon up-and-down method, this study investigated the median effective dose (ED50) of oxycodone that could be combined with intercostal nerve block (INB) to effectively control APP after thoracoscopic pulmonary surgery in patients of different ages.
Methods: This is a prospective, interventional, dose-finding study. Patients undergoing thoracoscopic lobar and sublobar resections under general anaesthesia will be selected and divided into 4 groups according to age and surgical method: the elderly lobectomy group (aged ≥ 65 years), the nonelderly lobectomy group (aged < 65 years), the elderly sublobar resection group (aged ≥ 65 years), and the nonelderly sublobar resection group (aged < 65 years). The study will be performed simultaneously in four experimental groups via the Dixon up-and-down method. The initial dose for the first patient in each group will be set to 0.1 mg/kg; the dose for the next patient will be determined by the response of the previous patient. The primary outcome is the ED50 of oxycodone.
Discussion: The results of this study are expected to provide an effective strategy for the management of APP following thoracoscopic pulmonary surgery and specifically to offer more accurate dose guidance for the use of oxycodone in older patients. This will not only improve the development of individualized pain management plans but also optimize the patient's postoperative recovery, reduce unnecessary drug side effects, and increase the overall comfort and quality of life of patients.
Trial registration: This study was registered on clinicaltrials.gov (NCT06534801) on August 1, 2024.
期刊介绍：
BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.
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