Optimal Effect-Site Concentration of Propofol for Hemodynamic Stability During Intubation with Dexmedetomidine: A Randomized Controlled Study.

BACKGROUND

This study aimed to determine the 95% effective concentration (EC) of propofol via target-controlled infusion (TCI) for endotracheal intubation at three different doses of dexmedetomidine.

METHODS

One hundred and eighty patients aged 18-60 and classified as American Society of Anesthesiologists (ASA) class I-II were enrolled to undergo general anesthesia. Patients were randomly assigned to one of the three groups (A, B, or C), receiving three different doses of dexmedetomidine (0.6, 0.8, or 1 μg/kg) infused over 10 min. Anesthesia was then induced with propofol TCI, followed by rocuronium. The biased coin design method was used to calculate the EC of propofol for successful intubation. The primary outcome endpoint was the EC of propofol for successful endotracheal intubation at each dexmedetomidine dose.

RESULTS

Sixty patients in each group completed the trial. The time from propofol administration to intubation in group C (132.5 ± 10.7 s) was significantly shorter compared to group A (140.2 ± 14.4 s, <0.0001) and group B (142.6 ± 13.2 s, =0.0037). Both the EC and the average total dose of propofol in group B [14.6 (10.8, 14.8) μg/mL and 3.6 ± 1.1 mg/kg] and C [12.7 (11.5, 12.8) μg/mL and 2.8 ± 1.0 mg/kg] were lower than those in group A [14.9 (4.5, 15.0) μg/mL and 3.8 ± 0.9 mg/kg] (<0.001). The incidence of hypotension and bradycardia during induction was low in each group.

CONCLUSION

The EC of propofol for endotracheal intubation across three different background doses of dexmedetomidine was determined. We suggest administering 1.0 μg/kg dexmedetomidine and then the EC of propofol for successful endotracheal intubation was 12.7 μg/mL.

REGISTRATION

Chinese Clinical Trial Registry; Registration number: ChiCTR2400089952, URL:https://www.chictr.org.cn/showproj.html?proj=221236.