Determination of the 90% effective dose of propofol combined with oliceridine or fentanyl for inhibiting the insertion response in upper gastrointestinal endoscopy: a dose-finding trial.

BACKGROUND

Propofol combined with opioids is commonly used for procedural sedation, enhancing patient tolerance and reducing the incidence of adverse events. This study aimed to determine the 90% effective dose (ED90) of propofol combined with fentanyl or oliceridine to inhibit the gastroscopy insertion response.

METHODS

This randomized, double-blind, dose-finding trial enrolled patients undergoing painless upper gastrointestinal endoscopy. Participants were assigned to receive propofol combined with fentanyl or oliceridine. A biased coin up-and-down sequential design was used to estimate the ED90 of propofol for inhibiting the gastroscopy insertion response. The primary outcome was the ED90 and 95% confidence intervals (CIs) for propofol in combination with either fentanyl or oliceridine for inhibiting the gastroscopy insertion response.

RESULTS

A total of 115 patients were included in the final analysis (59 in Group F and 56 in Group O). The ED90 of propofol required to suppress the gastroscopy insertion response was 1.942 (1.709-2.494) mg/kg in Group F and 1.871 (1.620-2.519) mg/kg in Group O. There were no significant between-group differences in the ED90 or in the incidence of adverse events (P > 0.05).

CONCLUSION

The ED90 of propofol for suppressing gastroscopy insertion responses was 1.942 mg/kg (95% CI, 1.709-2.494) with fentanyl and 1.871 mg/kg (95% CI, 1.620-2.519) with oliceridine. The substantial overlap of the confidence intervals suggests comparable propofol requirements for the two opioid adjuncts under the study conditions. These findings provide quantitative reference data to guide individualized initial propofol dosing during upper gastrointestinal endoscopy.

CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/, identifier ChiCTR2500096971.