Lan Hongmeng, Liu Susu, Liao Yeqing, Xu Bing, Lin Yuliu, Wu Xiaoshan, Chen Qiuling, Chen Huihe, Guan Xuehai
Department of Anesthesiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Department of Rehabilitation, the People`s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China.
Drug Des Devel Ther. 2024 Dec 31;18:6487-6497. doi: 10.2147/DDDT.S490907. eCollection 2024.
Opioids are used to suppress cough during fiberoptic bronchoscopy (FOB). However, evidence regarding the optimal dose of remifentanil during FOB under ciprofol sedation is limited. This study aimed to investigate the effective concentration (EC) of remifentanil required to suppress bronchoscopy responses during FOB under ciprofol sedation in elderly patients.
Elderly patients aged 60 to 90 years with American Society of Anesthesiologists (ASA) physical status I-III, scheduled for FOB, were enrolled. Patients were assigned to either the male or the female group. Remifentanil was administered intravenously prior to ciprofol administration. The endpoints included responses to FOB, such as vocal cords movement, coughing, and body movement. The EC and EC values of remifentanil required to alleviate the responses to FOB were calculated using Dixon's up-and-down method for both male and female groups. Probit analysis was used to generate a dose-response curve.
Thirty-nine patients (19 males and 20 females) were enrolled. The EC values (plasma concentration) of remifentanil for blunting FOB responses under ciprofol sedation were 3.25 (2.75 to 3.26) ng/mL and 2.25 (1.75 to 2.25) ng/mL in males and females, respectively ( = 0.0023). Probit analysis indicated that the EC of remifentanil required to suppress responses to FOB under ciprofol sedation was 3.102 [95% confidence interval (CI):2.694 to 3.749] ng/mL and 2.052 [95% CI: 1.345 to 2.750] ng/mL in males and females, respectively. The EC of remifentanil required to suppress responses to FOB under ciprofol sedation was 3.741 [95% CI: 3.366 to 7.699] ng/mL and 2.943 [95% CI: 2.456 to 9.533] ng/mL in males and females, respectively.
The results indicate differences between males and females in the EC and EC of remifentanil needed to suppress responses to FOB under ciprofol sedation while preserving spontaneous breathing in elderly patients.
The study was registered with chictr.org.cn (ChiCTR2300077720; 17 November 2023).
阿片类药物用于在纤维支气管镜检查（FOB）期间抑制咳嗽。然而，关于丙泊酚镇静下FOB期间瑞芬太尼最佳剂量的证据有限。本研究旨在调查老年患者在丙泊酚镇静下FOB期间抑制支气管镜检查反应所需的瑞芬太尼有效浓度（EC）。
纳入年龄在60至90岁、美国麻醉医师协会（ASA）身体状况为I-III级、计划进行FOB的老年患者。患者被分为男性组或女性组。在给予丙泊酚之前静脉注射瑞芬太尼。终点包括对FOB的反应，如声带运动、咳嗽和身体运动。使用狄克逊上下法计算男性和女性组减轻FOB反应所需的瑞芬太尼EC和EC值。采用概率分析生成剂量反应曲线。
共纳入39例患者（19例男性和20例女性）。丙泊酚镇静下瑞芬太尼抑制FOB反应的EC值（血浆浓度）男性为3.25（2.75至3.26）ng/mL，女性为2.25（1.75至2.25）ng/mL（P = 0.0023）。概率分析表明，丙泊酚镇静下抑制FOB反应所需的瑞芬太尼EC男性为3.102 [95%置信区间（CI）：2.694至3.749] ng/mL，女性为2.052 [95% CI：1.345至2.750] ng/mL。丙泊酚镇静下抑制FOB反应所需的瑞芬太尼EC男性为3.741 [95% CI：3.366至7.699] ng/mL，女性为2.943 [95% CI：2.456至9.533] ng/mL。
结果表明，在老年患者丙泊酚镇静下抑制FOB反应并保持自主呼吸时，男性和女性在瑞芬太尼的EC和EC方面存在差异。
该研究已在chictr.org.cn注册（ChiCTR2300077720；2023年11月17日）。
