The median effective dose of ciprofol combined with a low-dose sufentanil for gastroscopy in obese or nonobese patients: a dose-finding study using Dixon’s up-and-down method

ObjectivesUnderstanding the different pharmacodynamic responses to narcotics in patients with or without obesity is particularly important for the safety of gastroscopy sedation. This study aimed to determine the median effective dose (ED50) of ciprofol combined with low-dose sufentanil to inhibit t...

Full description

Saved in:
Bibliographic Details
Main Authors: Jie Zhao, Yixiao Zhang, Guowei Su, Shaoyi Wang, Xiaolin Zhang, Guoxiang Wang, Gang Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Pharmacology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1521715/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850024506897203200
author Jie Zhao
Jie Zhao
Yixiao Zhang
Guowei Su
Shaoyi Wang
Xiaolin Zhang
Guoxiang Wang
Gang Chen
author_facet Jie Zhao
Jie Zhao
Yixiao Zhang
Guowei Su
Shaoyi Wang
Xiaolin Zhang
Guoxiang Wang
Gang Chen
author_sort Jie Zhao
collection DOAJ
description ObjectivesUnderstanding the different pharmacodynamic responses to narcotics in patients with or without obesity is particularly important for the safety of gastroscopy sedation. This study aimed to determine the median effective dose (ED50) of ciprofol combined with low-dose sufentanil to inhibit the response to gastroscope insertion in obese or nonobese patients.MethodsA total of 27 obese patients (BMI 30–40 kg/m2) and 25 nonobese patients (BMI 18–25 kg/m2), aged between 18 and 65 years, with ASA physical status of 1–2, were included in this study. All patients underwent painless gastroscopy and received intravenous sufentanil at a dose of 0.1 μg/kg, followed by ciprofol administration. The initial dose of ciprofol for the first patient in both groups was 0.4 mg/kg, the subsequent dose was determined by the response of the previous patient to gastroscope insertion (cough, choking, body movement, etc.) using Dixon’s up-and-down method. The dose was increased or decreased by 0.05 mg/kg depending on the observed responses. Data collection continued until 7 crossover points were obtained. Probit regression and bootstrapping methods were employed to calculate the median effective dose (ED50) and 95% confidence intervals (CIs). The ED50 values were then compared between the obese and nonobese patient groups.ResultsThe ED50 of ciprofol combined with sufentanil inhibiting response to gastroscope insertion in patients with obesity was 0.186 mg/kg with 95% CI of 0.153∼0.209 mg/kg, was significantly lower than patients with nonobese was 0.237 mg/kg with 95% CI of 0.206∼0.253 mg/kg (p < 0.05).ConclusionThe ED50 values of ciprofol combined with sufentanil inhibiting response to gastroscope insertion in patients with obesity was lower than in patients with normal weight.Trial registrationhttps://www.chictr.org.cn/bin/project/edit?pid=202873, identifier ChiCTR2300074216.
format Article
id doaj-art-3171fdbf3e4d4b39bc788ea4708dfb79
institution DOAJ
issn 1663-9812
language English
publishDate 2025-02-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Pharmacology
spelling doaj-art-3171fdbf3e4d4b39bc788ea4708dfb792025-08-20T03:01:06ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-02-011610.3389/fphar.2025.15217151521715The median effective dose of ciprofol combined with a low-dose sufentanil for gastroscopy in obese or nonobese patients: a dose-finding study using Dixon’s up-and-down methodJie Zhao0Jie Zhao1Yixiao Zhang2Guowei Su3Shaoyi Wang4Xiaolin Zhang5Guoxiang Wang6Gang Chen7Department of Anesthesiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Anesthesiology, Hangzhou Red Cross Hospital, Hangzhou, ChinaDepartment of Anesthesiology, Hangzhou Red Cross Hospital, Hangzhou, ChinaDepartment of Anesthesiology, Hangzhou Red Cross Hospital, Hangzhou, ChinaDepartment of Anesthesiology, Hangzhou Red Cross Hospital, Hangzhou, ChinaDepartment of Anesthesiology, Hangzhou Red Cross Hospital, Hangzhou, ChinaDepartment of Anesthesiology, Hangzhou Red Cross Hospital, Hangzhou, ChinaDepartment of Anesthesiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaObjectivesUnderstanding the different pharmacodynamic responses to narcotics in patients with or without obesity is particularly important for the safety of gastroscopy sedation. This study aimed to determine the median effective dose (ED50) of ciprofol combined with low-dose sufentanil to inhibit the response to gastroscope insertion in obese or nonobese patients.MethodsA total of 27 obese patients (BMI 30–40 kg/m2) and 25 nonobese patients (BMI 18–25 kg/m2), aged between 18 and 65 years, with ASA physical status of 1–2, were included in this study. All patients underwent painless gastroscopy and received intravenous sufentanil at a dose of 0.1 μg/kg, followed by ciprofol administration. The initial dose of ciprofol for the first patient in both groups was 0.4 mg/kg, the subsequent dose was determined by the response of the previous patient to gastroscope insertion (cough, choking, body movement, etc.) using Dixon’s up-and-down method. The dose was increased or decreased by 0.05 mg/kg depending on the observed responses. Data collection continued until 7 crossover points were obtained. Probit regression and bootstrapping methods were employed to calculate the median effective dose (ED50) and 95% confidence intervals (CIs). The ED50 values were then compared between the obese and nonobese patient groups.ResultsThe ED50 of ciprofol combined with sufentanil inhibiting response to gastroscope insertion in patients with obesity was 0.186 mg/kg with 95% CI of 0.153∼0.209 mg/kg, was significantly lower than patients with nonobese was 0.237 mg/kg with 95% CI of 0.206∼0.253 mg/kg (p < 0.05).ConclusionThe ED50 values of ciprofol combined with sufentanil inhibiting response to gastroscope insertion in patients with obesity was lower than in patients with normal weight.Trial registrationhttps://www.chictr.org.cn/bin/project/edit?pid=202873, identifier ChiCTR2300074216.https://www.frontiersin.org/articles/10.3389/fphar.2025.1521715/fullciprofolpatients with obesitypainless gastroscopysufentanildosage exploration
spellingShingle Jie Zhao
Jie Zhao
Yixiao Zhang
Guowei Su
Shaoyi Wang
Xiaolin Zhang
Guoxiang Wang
Gang Chen
The median effective dose of ciprofol combined with a low-dose sufentanil for gastroscopy in obese or nonobese patients: a dose-finding study using Dixon’s up-and-down method
Frontiers in Pharmacology
ciprofol
patients with obesity
painless gastroscopy
sufentanil
dosage exploration
title The median effective dose of ciprofol combined with a low-dose sufentanil for gastroscopy in obese or nonobese patients: a dose-finding study using Dixon’s up-and-down method
title_full The median effective dose of ciprofol combined with a low-dose sufentanil for gastroscopy in obese or nonobese patients: a dose-finding study using Dixon’s up-and-down method
title_fullStr The median effective dose of ciprofol combined with a low-dose sufentanil for gastroscopy in obese or nonobese patients: a dose-finding study using Dixon’s up-and-down method
title_full_unstemmed The median effective dose of ciprofol combined with a low-dose sufentanil for gastroscopy in obese or nonobese patients: a dose-finding study using Dixon’s up-and-down method
title_short The median effective dose of ciprofol combined with a low-dose sufentanil for gastroscopy in obese or nonobese patients: a dose-finding study using Dixon’s up-and-down method
title_sort median effective dose of ciprofol combined with a low dose sufentanil for gastroscopy in obese or nonobese patients a dose finding study using dixon s up and down method
topic ciprofol
patients with obesity
painless gastroscopy
sufentanil
dosage exploration
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1521715/full
work_keys_str_mv AT jiezhao themedianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT jiezhao themedianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT yixiaozhang themedianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT guoweisu themedianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT shaoyiwang themedianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT xiaolinzhang themedianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT guoxiangwang themedianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT gangchen themedianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT jiezhao medianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT jiezhao medianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT yixiaozhang medianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT guoweisu medianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT shaoyiwang medianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT xiaolinzhang medianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT guoxiangwang medianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod
AT gangchen medianeffectivedoseofciprofolcombinedwithalowdosesufentanilforgastroscopyinobeseornonobesepatientsadosefindingstudyusingdixonsupanddownmethod