Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
J Clin Pharm Ther. 2021 Apr;46(2):484-491. doi: 10.1111/jcpt.13312. Epub 2020 Nov 20.
Propofol is effective in sedation for upper gastrointestinal (UGI) endoscopy. However, the optimum dose is ill-defined. This study aimed to estimate the effective dose of propofol mono-sedation for successful endoscope insertion in healthy, non-obese Chinese adults undergoing single UGI endoscopy.
Twenty-six adult patients undergoing elective single UGI endoscopy were enrolled in this study. A modified Dixon's up-and-down method was utilized to assess the effective dose of propofol for successful endoscope insertion. The initial dose of propofol administered, 1.6 mg/kg, was adjusted with 0.1 mg/kg as a step size. The patient's responses to endoscope insertion were classified as either 'movement' or 'no movement'. When patient's responses were changed from 'movement' to 'no movement' or from 'no movement' to 'movement', a crossover was defined. After eight crossovers had been obtained, patient recruitment was stopped. The mean of midpoints of all crossovers obtained by the modified Dixon's up-and-down method in all 26 patients was defined as calculated median effective dose (ED ) of propofol for successful endoscope insertion. Furthermore, probit regression analysis was used to determine the dose of propofol where 50% (ED ) and 95% (ED ) of endoscope insertion attempts were successful.
The calculated ED of propofol for successful endoscope insertion was 1.89 ± 0.12 mg/kg. The probit regression analysis showed that ED and ED of propofol for successful endoscope insertion were 1.90 mg/kg (95% CI, 1.78-2.10 mg/kg) and 2.15 mg/kg (95% CI, 2.01-3.56 mg/kg), respectively. No any patient had hypoxaemia and gag reflex during the UGI endoscopy with propofol mono-sedation.
In healthy, non-obese Chinese adults, propofol mono-sedation can provide excellent conditions of UGI endoscopy and the estimated ED of propofol for successful endoscope insertion is 1.89 ± 0.12 mg/kg.
异丙酚在为上消化道（UGI）内镜检查提供镇静方面有效。然而，最佳剂量尚未确定。本研究旨在估计异丙酚单镇静在接受单 UGI 内镜检查的健康、非肥胖中国成年人中成功插入内镜的有效剂量。
本研究纳入了 26 名接受择期单 UGI 内镜检查的成年患者。采用改良 Dixon 上下法评估异丙酚用于成功插入内镜的有效剂量。初始剂量为 1.6mg/kg，以 0.1mg/kg 为步长进行调整。将患者对内镜插入的反应分为“运动”或“无运动”。当患者的反应从“运动”变为“无运动”或从“无运动”变为“运动”时，定义为交叉。获得八个交叉后，停止患者招募。所有 26 名患者通过改良 Dixon 上下法获得的所有交叉中点的平均值被定义为计算出的异丙酚成功插入内镜的中位有效剂量（ED）。此外，还进行了概率单位回归分析，以确定 50%（ED）和 95%（ED）内镜插入尝试成功的异丙酚剂量。
异丙酚成功插入内镜的计算 ED 为 1.89±0.12mg/kg。概率单位回归分析显示，异丙酚成功插入内镜的 ED 和 ED 分别为 1.90mg/kg（95%CI，1.78-2.10mg/kg）和 2.15mg/kg（95%CI，2.01-3.56mg/kg）。在接受异丙酚单镇静的 UGI 内镜检查中，没有任何患者出现低氧血症和呕吐反射。
在健康、非肥胖的中国成年人中，异丙酚单镇静可提供良好的 UGI 内镜检查条件，异丙酚成功插入内镜的估计 ED 为 1.89±0.12mg/kg。
