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已发表论文
右美托咪定联合丙泊酚用于宫腔镜手术患者的最佳剂量：一项随机对照试验
Authors Xu H , Peng T, Xie D, Dong B, An T, Wang F
Received 3 June 2025
Accepted for publication 8 September 2025
Published 16 September 2025 Volume 2025:19 Pages 8441—8450
DOI https://doi.org/10.2147/DDDT.S544566
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Tin Wui Wong
Hongchun Xu,1,* Tong Peng,2,3,* Dan Xie,1,* Biqian Dong,1,* Tiantian An,1,* Fangjun Wang1
1Department of Anesthesia, Affiliated Hospital of North Sichuan Medical College, Nanchong City, People’s Republic of China; 2Department of anesthesia, North sichuan medical college, Nanchong City, People’s Republic of China; 3Department of Anesthesia, Nanchong Central Hospital, Nanchong City, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Fangjun Wang, Department of anesthesia, Affiliated hospital of north sichuan medical college, Nanchong City, People’s Republic of China, Email wfjlxy006@126.com
Background: Dexmedetomidine has been reported to be utilized in conjunction with propofol during hysteroscopic surgery. However, both dexmedetomidine and propofol have benefits and side-effects, and the optimal doses of dexmedetomidine when utilized in combination with propofol during hysteroscopic surgery remain unestablished.
Methods: One hundred and fifty patients undergoing hysteroscopic surgery at the affiliated hospital of North Sichuan Medical College were randomly divided into five groups and administered dexmedetomidine at a dose of 0.4 μg/kg, 0.6 μg/kg, 0.8 μg/kg, or 1.0 μg/kg, or saline, prior to anesthesia induction. Before the surgery, propofol was administered via target-controlled infusion using a pump with the Marsh model. The EC50 of propofol was determined using an up-and-down sequential method with an adjacent concentration gradient of 1.2 to prevent purposeful movements. Hemodynamic parameters and adverse events related to anesthesia were also evaluated. The duration of the procedure and recovery, the amount of propofol required, and the postoperative recovery characteristics were documented.
Results: The EC50 of propofol was significantly lower in the Dex 0.6, Dex 0.8, and Dex 1.0 groups compared to the S group (p< 0.05). As the dose of dexmedetomidine increased, the demand for propofol gradually decreased (p< 0.01), whereas the incidence of respiratory depression decreased (p< 0.01). Nevertheless, the incidence of bradycardia slightly increased (p=0.02). No significant differences in the incidence of hypotension were observed among the five groups (p> 0.05). The patients in the Dex1.0 groups had higher postoperative comfort scores than those in the S group. At both t1 and t2, Ramsay scores were higher in the Dex0.8 and Dex1.0 groups than in the S group (p< 0.05). No significant differences were observed in the VAS scores among the five groups.
Conclusion: Dexmedetomidine 0.8 μg/kg offers an optimal balance between propofol-sparing effects, sedation quality, and manageable side effects for hysteroscopic surgery.
Trial Registration: Date of registration: 24/05/2020, registration number: ChiCTR2000033220.
Keywords: propofol, EC50, dexmedetomidine, optimal dose, hysteroscopic surgery
1Department of Anesthesia, Affiliated Hospital of North Sichuan Medical College, Nanchong City, People’s Republic of China; 2Department of anesthesia, North sichuan medical college, Nanchong City, People’s Republic of China; 3Department of Anesthesia, Nanchong Central Hospital, Nanchong City, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Fangjun Wang, Department of anesthesia, Affiliated hospital of north sichuan medical college, Nanchong City, People’s Republic of China, Email wfjlxy006@126.com
Background: Dexmedetomidine has been reported to be utilized in conjunction with propofol during hysteroscopic surgery. However, both dexmedetomidine and propofol have benefits and side-effects, and the optimal doses of dexmedetomidine when utilized in combination with propofol during hysteroscopic surgery remain unestablished.
Methods: One hundred and fifty patients undergoing hysteroscopic surgery at the affiliated hospital of North Sichuan Medical College were randomly divided into five groups and administered dexmedetomidine at a dose of 0.4 μg/kg, 0.6 μg/kg, 0.8 μg/kg, or 1.0 μg/kg, or saline, prior to anesthesia induction. Before the surgery, propofol was administered via target-controlled infusion using a pump with the Marsh model. The EC50 of propofol was determined using an up-and-down sequential method with an adjacent concentration gradient of 1.2 to prevent purposeful movements. Hemodynamic parameters and adverse events related to anesthesia were also evaluated. The duration of the procedure and recovery, the amount of propofol required, and the postoperative recovery characteristics were documented.
Results: The EC50 of propofol was significantly lower in the Dex 0.6, Dex 0.8, and Dex 1.0 groups compared to the S group (p< 0.05). As the dose of dexmedetomidine increased, the demand for propofol gradually decreased (p< 0.01), whereas the incidence of respiratory depression decreased (p< 0.01). Nevertheless, the incidence of bradycardia slightly increased (p=0.02). No significant differences in the incidence of hypotension were observed among the five groups (p> 0.05). The patients in the Dex1.0 groups had higher postoperative comfort scores than those in the S group. At both t1 and t2, Ramsay scores were higher in the Dex0.8 and Dex1.0 groups than in the S group (p< 0.05). No significant differences were observed in the VAS scores among the five groups.
Conclusion: Dexmedetomidine 0.8 μg/kg offers an optimal balance between propofol-sparing effects, sedation quality, and manageable side effects for hysteroscopic surgery.
Trial Registration: Date of registration: 24/05/2020, registration number: ChiCTR2000033220.
Keywords: propofol, EC50, dexmedetomidine, optimal dose, hysteroscopic surgery