Determination of the ED95 of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography  

作　　者：Yi Zou Na Li Liu-Jia-Zi Shao Fu-Kun Liu Fu-Shan Xue Xing Tao 

机构地区：[1]Department of Anesthesiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China

出　　处：《World Journal of Clinical Cases》2022年第9期2773-2782,共10页世界临床病例杂志

基　　金：Supported by the Research Foundation of Beijing Friendship Hospital,Capital Medical University,No. yyqdkt2018-16;the Beijing Municipal Administration of Hospitals’ Youth Program,No. QML20190101;the Scientific Research Common Program of Beijing Municipal Commission of Education,No. KM202010025021

摘　　要：BACKGROUND Sedation during endoscopic ultrasonography(EUS)poses many challenges and moderate-to-deep sedation are often required.The conventional method to preform moderate-to-deep sedation is generally intravenous benzodiazepine alone or in combination with opioids.However,this combination has some limitations.Intranasal medication delivery may be an alternative to this sedation regimen.AIM To determine,by continual reassessment method(CRM),the minimal effective dose of intranasal sufentanil(SUF)when combined with intranasal dexmedetomidine(DEX)for moderate sedation of EUS in at least 95%of patients(ED95).METHODS Thirty patients aged 18-65 and scheduled for EUS were recruited in this study.Subjects received intranasal DEX and SUF for sedation.The dose of DEX(1μg/kg)was fixed,while the dose of SUF was assigned sequentially to the subjects using CRM to determine ED95.The sedation status was assessed by modified observer’s assessment of alertness/sedation(MOAA/S)score.The adverse events and the satisfaction scores of patients and endoscopists were recorded.RESULTS The ED95 was intranasal 0.3μg/kg SUF when combined with intranasal 1μg/kg DEX,with an estimated probability of successful moderate sedation for EUS of 94.9%(95%confidence interval:88.1%-98.9%).When combined with intranasal 1μg/kg DEX,probabilities of successful moderate sedation at each dose level of intranasal SUF were as follows:0μg/kg SUF,52.8%;0.1μg/kg SUF,75.4%;0.2μg/kg SUF,89.9%;0.3μg/kg SUF,94.9%;0.4μg/kg SUF,98.0%;0.5μg/kg SUF,99.0%.CONCLUSION The ED95 needed for moderate sedation for EUS is intranasal 0.3μg/kg SUF when combined with intranasal 1μg/kg DEX,based on CRM.

关 键 词：Moderate sedation Intranasal administration DEXMEDETOMIDINE SUFENTANIL Continual reassessment method Endoscopic ultrasonography 

分 类 号：R614[医药卫生—麻醉学]