复合丙泊酚时奥赛利定用于亚临床肥胖患者双向内窥镜检查的半数有效剂量OA

AIM:To determine the median effec-tive dose(ED50)and 95%effective dose(ED95)of oliceridine based on lean body weight(LBW)when combined with different propofol doses for same-visit bidirectional endoscopy in patients with pre-clinical obesity.METHODS:Fifty-four ASA physical status II-III preclinical obesity patients were ran-domized to receive propofol 2.0 mg/kg LBW(Group P1,n=28)or 2.5 mg/kg LBW(Group P2,n=26)com-bined with oliceridine(initial dose 0.02 mg/kg LBW,adjusted in±0.005 mg/kg LBW increments).A posi-tive response was defined as coughing or body movement≥grade 2 during gastroscopy(requiring procedure suspension or anesthetic deepening).The study terminated after observing seven crossover points(positive-to-negative response transitions).ED values were calculated using Probit regression analysis.Hemodynamics and adverse events were recorded.RESULTS:Patient demo-graphics(gender,age,BMI,LBW)showed no inter-group differences.Based on LBW,the ED50 and ED95 of oliceridine in Group P1 were 0.037 mg/kg(95%CI:0.033-0.042)and 0.048 mg/kg(95%CI:0.043-0.075),respectively;in Group P2,the ED50 and ED95 were 0.012 mg/kg(95%CI:0.004-0.016)and 0.023 mg/kg(95%CI:0.017-0.063),respective-ly.Increasing propofol from 2.0 mg/kg to 2.5 mg/kg reduced oliceridine ED50 by 52.1%and ED95 by 67.6%(P<0.001),indicating synergism.Group P2 had lower incidence of respiratory depression(SpO2<90%:30.8%vs.46.4%)but higher rates of brady-cardia(11.5%vs.0%)and hypotension(15.4%vs.3.6%)(all P>0.05).Injection pain(P1:25.0%vs.P2:26.9%)and recovery/discharge times did not differ significantly.No nausea,vomiting,or post-dis-charge adverse events occurred in either group.CONCLUSION:Propofol and oliceridine exhibit dose-dependent synergism.For preclinical obesity patients,propofol 2.5 mg/kg LBW combined with oliceridine 0.023 mg/kg LBW is recommended,pro-viding effective anesthesia with reduced oliceridine requirements,lower respiratory depression risk,and satisfactory recovery.