Xue Zhouya, Liu Xiang, Qian Weisheng, Yang Nan, Pan Yongyi, Zhou Yong, Jiang Wei, Li Feng, Qian Bin
Department of Anesthesiology, The First People's Hospital of Yancheng, The Yancheng Clinical College of Xuzhou Medical University, Yancheng, Jiangsu, People's Republic of China.
Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.
Drug Des Devel Ther. 2025 May 1;19:3577-3587. doi: 10.2147/DDDT.S494972. eCollection 2025.
Ciprofol, a recently developed intravenous anesthetic, whereas sufentanil is a widely used adjuvant for gastroenteroscopy sedation. The recommended dosage of ciprofol for obese patients remains unclear. Our study aimed to determine the median effective dose (ED) of ciprofol in combination with sufentanil for obese patients undergoing gastroscopy sedation.
A total of 70 patients undergoing painless gastroscopy from July 2024 to September 2024 were recruited. Patients were assigned to the obese group (body mass index [BMI]≥28 kg/m, n=34) and non-obese group (18.5 kg/m ≤BMI<24 kg/m, n=36). All patients received 0.1 μg/kg of sufentanil, and the ciprofol dose was determined by the modified Dixon sequential method with an initial dose of 0.4 mg/kg and a dose gradient of 0.01 mg/kg. The dose of ciprofol administered to the subsequent patient was determined by the response of the preceding patient. The response referred to the patient's cough, swallowing, and body movement during gastroscope insertion. The primary outcome was the ED of ciprofol in each group, while the secondary outcomes comprised the incidences of hypoxemia, hypotension, bradycardia, postoperative nausea and vomiting (PONV), and hemodynamic parameters.
The ED of ciprofol was 0.278 mg/kg (95% confidence interval [CI]: 0.226-0.297 mg/kg) in the obese group and 0.347 mg/kg (95% CI: 0.329-0.360 mg/kg) in the non-obese group for gastroscopy sedation. The ED of ciprofol in the obese group was significantly lower than that in the non-obese group (<0.05). The incidence of hypoxemia in the obese group was significantly higher than that in the non-obese group (<0.05).
Obesity affected the ED of ciprofol, suggesting that the ciprofol dosage should be adjusted in obese patients.
环泊酚是一种新开发的静脉麻醉药，而舒芬太尼是一种广泛用于胃镜检查镇静的辅助药物。肥胖患者中环泊酚的推荐剂量仍不明确。我们的研究旨在确定环泊酚联合舒芬太尼用于肥胖患者胃镜检查镇静的半数有效剂量（ED）。
招募了2024年7月至2024年9月期间共70例行无痛胃镜检查的患者。患者被分为肥胖组（体重指数[BMI]≥28kg/m²，n = 34）和非肥胖组（18.5kg/m²≤BMI<24kg/m²，n = 36）。所有患者均接受0.1μg/kg的舒芬太尼，环泊酚剂量采用改良的Dixon序贯法确定，初始剂量为0.4mg/kg，剂量梯度为0.01mg/kg。根据前一位患者的反应确定给予下一位患者的环泊酚剂量。反应是指患者在胃镜插入过程中的咳嗽、吞咽和身体移动。主要结局是每组中环泊酚的ED，次要结局包括低氧血症、低血压、心动过缓、术后恶心呕吐（PONV）的发生率以及血流动力学参数。
肥胖组中环泊酚用于胃镜检查镇静的ED为0.278mg/kg（95%置信区间[CI]：0.226 - 0.297mg/kg），非肥胖组为0.347mg/kg（95%CI：0.329 - 0.360mg/kg）。肥胖组中环泊酚的ED显著低于非肥胖组（P<0.05）。肥胖组中低氧血症的发生率显著高于非肥胖组（P<0.05）。
肥胖影响环泊酚的ED，提示肥胖患者中环泊酚剂量应进行调整。
