Tang Lili, Ye Chenxuan, Wang Nan, Chen Chen, Chen Sirui, Gao Shan, Liu Xuesheng
Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Biomedical Engineering, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China.
Front Pharmacol. 2022 Sep 20;13:1014486. doi: 10.3389/fphar.2022.1014486. eCollection 2022.
Propofol is the most widely administered intravenous anesthetic to induce deep sedation for gastroscopy procedures. Coadministration of nalbuphine can provide analgesia and sedation to patients experiencing visceral pain, thereby decreasing the amount of propofol needed and reducing the risk of propofol-induced adverse events. We carried out this study to determine the median effective dose (ED50) of propofol in combination with different dosages of nalbuphine and the optimal dosage of nalbuphine during painless gastroscopy. We recruited sixty-five patients aged 18-60 years who underwent elective painless gastroscopy. A total of sixty-one patients were allocated randomly to the N1 group (nalbuphine 0.1 mg/kg) or N2 group (nalbuphine 0.15 mg/kg). Three minutes after administration of nalbuphine, patients received a preset dose of propofol at 2.0 mg/kg with a dose gradient of 0.2 mg/kg according to Dixon's "up-and-down" method. The primary outcome was the ED50 of propofol in combination with nalbuphine. Hemodynamic parameters, recovery time, pain score, and adverse events were recorded as secondary outcomes. The ED50 of propofol in the N2 group was significantly lower than that observed in the N1 group ( < 0.01). Using probit analysis, the ED50 and ED95 of propofol were 1.632 mg/kg and 2.759 mg/kg in the N1 group and 1.111 mg/kg and 2.243 mg/kg in the N2 group, respectively. The incidence of hypotension in the N2 group was lower than that in the N1 group ( < 0.05), and the recovery time was shorter than that of the N1 group ( < 0.05). In adult patients, 0.15 mg/kg nalbuphine led to a significant reduction in the ED50 and ED95 of propofol during gastroscopy. This dose of nalbuphine also reduced the incidence of hypotension and shortened the recovery time. Therefore, nalbuphine (0.15 mg/kg) combined with propofol is a safe option for enhancing recovery after painless gastroscopy in adult patients. : [https://www.chictr.org.cn/edit.aspx?pid=126699&htm=4], identifier [ChiCTR2100053204].
丙泊酚是用于胃镜检查诱导深度镇静最广泛使用的静脉麻醉药。联合使用纳布啡可为内脏疼痛患者提供镇痛和镇静作用，从而减少所需丙泊酚的用量并降低丙泊酚引起不良事件的风险。我们开展这项研究以确定无痛胃镜检查期间丙泊酚与不同剂量纳布啡联合使用时丙泊酚的半数有效剂量（ED50）以及纳布啡的最佳剂量。我们招募了65名年龄在18至60岁之间接受择期无痛胃镜检查的患者。总共61名患者被随机分配到N1组（纳布啡0.1mg/kg）或N2组（纳布啡0.15mg/kg）。在给予纳布啡3分钟后，患者按照迪克森“上下法”接受预设剂量的丙泊酚，初始剂量为2.0mg/kg，剂量梯度为0.2mg/kg。主要结局是丙泊酚与纳布啡联合使用时的ED50。记录血流动力学参数、恢复时间、疼痛评分和不良事件作为次要结局。N2组丙泊酚的ED50显著低于N1组（<0.01）。使用概率单位分析，N1组丙泊酚的ED50和ED95分别为1.632mg/kg和2.759mg/kg，N2组分别为1.111mg/kg和2.243mg/kg。N2组低血压的发生率低于N1组（<0.05），恢复时间短于N1组（<0.05）。在成年患者中，0.15mg/kg纳布啡导致无痛胃镜检查期间丙泊酚的ED50和ED95显著降低。该剂量的纳布啡还降低了低血压的发生率并缩短了恢复时间。因此，纳布啡（0.15mg/kg）联合丙泊酚是成年患者无痛胃镜检查后促进恢复的安全选择。: [https://www.chictr.org.cn/edit.aspx?pid=126699&htm=4]，标识符[ChiCTR2100053204]
