Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Republic of Korea
Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea
Turk J Med Sci. 2021 Feb 26;51(1):102-110. doi: 10.3906/sag-2004-63.
BACKGROUND/AIM: Preoperative intravenous oxycodone may help to prevent or attenuate intubation-related hemodynamic responses (IRHRs), but its pharmacokinetics differs according to age and sex. Therefore, we investigated the 95% effective dose (ED95) of intravenous oxycodone for attenuating all IRHRs, depending on the age and sex of the study population.
All patients were allocated to one of 6 groups: 1) 20–40 year old males, 2) 41–65yearold males, 3) 66–80 year old males, 4) 20–40 year old females, 5) 41–65yearold females, and 6) 66–80 year old females (groups YM, OM, EM, YF, OF, and EF, respectively). Using Dixon’s up-and-down method, the first patient in each group was slowly injected with intravenous oxycodone (0.1 mg kg–1) 20 min before intubation. The subsequent patient received the next oxycodone dose, which was decreased or increased by 0.01 mg kg–1, depending on the “success” or “failure” of attenuation of all IRHRs to within 20% of the baseline values at 1 min after intubation in the previous patient. After obtaining 8 crossover points, predictive ED95 was estimated with probit regression analysis.
ED95 varied greatly according to age and sex. ED95was 0.133 mg kg–1, 0.181 mg kg–1, 0.332 mg kg–1, 0.183 mg kg–1, 0.108 mg kg–1, and 0.147 mg kg–1in groups YM, OM, EM, YF, OF, and EF, respectively.
ED95 is higher in males with increasing age but is ambiguous for females. ED95 is higher in males than in females over 40 years of age but is higher in females than in males under 41 years of age. However, after considering the age and sex of the study population, these results can be used as reference doses for further studies to verify the clinical effects of oxycodone for attenuating all IRHRs.
背景/目的：术前静脉注射羟考酮可能有助于预防或减轻插管相关的血流动力学反应（IRHRs），但它的药代动力学因年龄和性别而异。因此，我们研究了静脉注射羟考酮的 95%有效剂量（ED95），以减轻所有 IRHRs，取决于研究人群的年龄和性别。
所有患者被分配到以下 6 组之一：1）20-40 岁男性，2）41-65 岁男性，3）66-80 岁男性，4）20-40 岁女性，5）41-65 岁女性，6）66-80 岁女性（分别为 YM、OM、EM、YF、OF 和 EF 组）。使用 Dixon 的上下法，每组的第一位患者在插管前 20 分钟缓慢静脉注射羟考酮（0.1mg/kg）。随后的患者接受下一个羟考酮剂量，根据前一位患者插管后 1 分钟内所有 IRHR 减轻至基础值的 20%以内的“成功”或“失败”，该剂量减少或增加 0.01mg/kg。在获得 8 个交叉点后，用概率回归分析估计预测 ED95。
ED95 根据年龄和性别有很大差异。ED95 分别为 0.133mg/kg、0.181mg/kg、0.332mg/kg、0.183mg/kg、0.108mg/kg 和 0.147mg/kg，在 YM、OM、EM、YF、OF 和 EF 组中。
年龄较大的男性 ED95 较高，但女性的 ED95 不明确。年龄较大的男性 ED95 高于女性，但 41 岁以下的女性高于男性。然而，在考虑研究人群的年龄和性别后，这些结果可作为参考剂量，用于进一步研究验证羟考酮减轻所有 IRHRs 的临床效果。
