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Effect of different doses of dexmedetomidine on the median effective concentration of propofol during gastrointestinal endoscopy:a randomized controlled trial
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  • Hai-yan Chen,
  • Fang Deng,
  • Shu-heng Tang,
  • Wen Liu,
  • Hua Yang,
  • Jin-Chao Song
Hai-yan Chen

Corresponding Author:[email protected]

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Shu-heng Tang
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Jin-Chao Song
Yangpu District Shidong Hospital of Shanghai
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Abstract

Background: Dexmedetomidine could be an ideal adjuvant to propofol during gastrointestinal endoscopy because it provides both analgesia and sedation without respiratory depression. This study investigates the effect of different doses of dexmedetomidine on the median effective concentration of propofol during gastrointestinal endoscopy. Methods: 90 adult patients were randomly assigned to Group Control , Group DEX0.5 (0.5 μg/kg dexmedetomidine), or Group DEX1.0 (1.0 μg/kg dexmedetomidine) . Anaesthesia during endoscopy was implemented by plasma target-controlled infusion (TCI) of propofol with different doses of dexmedetomidine. TCI concentration of the first patient for each group was 2.5 μg/ml and the consecutive adjacent concentration gradient was 0.5 μg/mL. EC50 of TCI propofol for gastrointestinal endoscopy was determined by using the modified Dixon’s up-and-down method. Cardiovascular variables were also measured. Results: EC50 of TCI propofol and 95% confidence interval (CI) for gastrointestinal endoscopy were, 3.77 (3.48-4.09), 2.51 (2.27-2.78) and 2.10 (1.90-2.33) μg/mL in Group Control, Group DEX0.5 and Group DEX1.0. The average percent change from baseline in HR was 2.8 (8.9), -7.4 (7.7) and -10.5 (8.8) (P<0.001), and the average percent change from baseline in MAP was -10.6 [-24.7; 3.5], -9.5 [-29.2; 11.4] and -4.0 [-27.3; 15.5] (P = 0.034) in Group Control, Group DEX0.5 and Group DEX1.0, respectively. Conclusions: Dexmedetomidine reduced the EC50 of TCI propofol. A 0.5-1 μg/kg dexmedetomidine caused a decrease in HR without bradycardia. The decrease in dosage of propofol with increasing doses of dexmedetomidine caused more stable MAP. Dexmedetomidine is an ideal adjuvant drug to propofol during gastrointestinal endoscopy.
17 Jun 2022Submitted to British Journal of Clinical Pharmacology
22 Jun 2022Submission Checks Completed
22 Jun 2022Assigned to Editor
24 Jun 2022Reviewer(s) Assigned
25 Aug 2022Review(s) Completed, Editorial Evaluation Pending
30 Aug 2022Editorial Decision: Revise Major
10 Oct 20221st Revision Received
11 Oct 2022Submission Checks Completed
11 Oct 2022Assigned to Editor
11 Oct 2022Review(s) Completed, Editorial Evaluation Pending
13 Oct 2022Reviewer(s) Assigned
22 Nov 2022Editorial Decision: Revise Minor
07 Dec 20222nd Revision Received
07 Dec 2022Submission Checks Completed
07 Dec 2022Assigned to Editor
07 Dec 2022Review(s) Completed, Editorial Evaluation Pending
12 Dec 2022Editorial Decision: Accept