Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Key Laboratory of Pediatric Anesthesiology of Ministry of Education, Wenzhou, Zhejiang Province, People's Republic of China.
Drug Des Devel Ther. 2024 Oct 5;18:4471-4480. doi: 10.2147/DDDT.S466603. eCollection 2024.
This study aimed to estimate the effect of different doses of fentanyl on the median effective dose (ED50) of ciprofol for attenuating the airway and motor response to laryngeal mask airway (LMA) insertion response in healthy children.
90 healthy preschool patients undergoing inguinal hernia repair surgery were randomly assigned to one of three groups: C0 (ciprofol+saline), C1 (ciprofol + fentanyl 1µg/kg), C2 (ciprofol + fentanyl 2µg/kg). Anesthesia was induced with either prepared fentanyl or saline, followed by ciprofol. The dose of ciprofol for each patient was determined using the up-and-down sequential study design. The primary outcome was the ED50 of ciprofol required for smooth LMA insertion in the three groups. Additionally, the time to loss of consciousness and any perioperative adverse events were recorded.
Compared with the C0 group, the ED50 (95% confidence interval) of ciprofol in the C1 and C2 groups were significantly lower (1.81 [1.73-1.90]mg/kg versus 0.67 [0.64-0.71]mg/kg and 0.48 [0.42-0.54] mg/kg, respectively; P<0.05). Additionally, the ED50 of ciprofol in the C2 group was lower than that in the C1 group (0.42 [0.42-0.54] mg/kg vs 0.67 [0.64-0.71]mg/kg; P<0.05). Furthermore, the time to loss of consciousness in the C1 and C2 groups decreased by 60% and 53%, respectively, compared to the C0 group. There were no significant differences in the incidence of drug-related hypotension after anesthesia induction among the three groups. No adverse events of hypoxia, bradycardia, or injection pain were observed in any groups.
In healthy, non-obese Chinese children undergoing elective inguinal hernia repair surgery, fentanyl 1 µg/kg and 2 µg/kg before ciprofol injection significantly reduced the ED50 of ciprofol for attenuating LMA response, with minimal occurrence of severe side effects.
本研究旨在评估不同剂量芬太尼对依托咪酯半数有效剂量（ED50）的影响，以减轻健康儿童喉罩气道（LMA）插入反应时的气道和运动反应。
90 例拟行腹股沟疝修补术的健康学龄前患儿被随机分为三组：C0 组（依托咪酯+生理盐水）、C1 组（依托咪酯+芬太尼 1μg/kg）、C2 组（依托咪酯+芬太尼 2μg/kg）。麻醉诱导时给予芬太尼或生理盐水，然后给予依托咪酯。采用上下序贯研究设计确定每位患者的依托咪酯剂量。主要结局为三组中 LMA 插入平稳时所需的依托咪酯 ED50。此外，还记录意识丧失时间和任何围手术期不良事件。
与 C0 组相比，C1 组和 C2 组依托咪酯的 ED50（95%置信区间）显著降低（1.81[1.73-1.90]mg/kg 比 0.67[0.64-0.71]mg/kg 和 0.48[0.42-0.54]mg/kg；P<0.05）。此外，C2 组依托咪酯的 ED50 低于 C1 组（0.42[0.42-0.54]mg/kg 比 0.67[0.64-0.71]mg/kg；P<0.05）。此外，与 C0 组相比，C1 组和 C2 组意识丧失时间分别减少了 60%和 53%。三组麻醉诱导后药物相关低血压的发生率无显著差异。三组均未观察到缺氧、心动过缓或注射痛等不良事件。
在接受择期腹股沟疝修补术的非肥胖中国健康儿童中，依托咪酯注射前给予芬太尼 1μg/kg 和 2μg/kg 可显著降低依托咪酯的 ED50，以减轻 LMA 反应，且严重不良反应发生率低。
