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已发表论文
低剂量右美托咪定降低成功插入胃镜所需丙泊酚中位有效剂量：一项前瞻性随机对照剂量探索试验
Authors Zhu Q , Hao PP, Cui LL , Liu FK , Xue FS
Received 29 September 2025
Accepted for publication 8 January 2026
Published 12 January 2026 Volume 2026:22 571057
DOI https://doi.org/10.2147/TCRM.S571057
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor De Yun Wang
Qian Zhu,1 Pei-Pei Hao,2 Ling-Li Cui,1 Fu-Kun Liu,1 Fu-Shan Xue1,3
1Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Anesthesiology, Maternal and Child Health Hospital of Henan Province, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 3Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fujian Provincial Hospital, Fuzhou, People’s Republic of China
Correspondence: Fu-Shan Xue, Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, NO. 95 Yong-An Road, Xi-Cheng District, Beijing, 100050, People’s Republic of China, Tel +86-13911177655, Email xuefushan@aliyun.com
Purpose: Patients undergoing painless gastrointestinal endoscopy (GIE) typically receive propofol-based sedation. However, the exact dose of propofol when combined with low-dose dexmedetomidine for this procedure remains unclear. The objective of this study was to determine and compare the median effective doses (ED50, the doses required for successful gastroscope insertion in 50% of the subjects) of propofol when used with low-dose dexmedetomidine (0.3 μg/kg) premedication versus propofol alone during painless GIE.
Patients and Methods: Adult outpatients aged 18 to 65 years scheduled for GIE were enrolled. Participants were randomized to receive either 0.9% saline (Group S) or 0.3 μg/kg of dexmedetomidine (Group D) intravenously over 5 min before induction with propofol. Using modified Dixon’s up-and-down method (MDUDM), the initial induction dose of propofol was 1.5 mg/kg, adjusted in a step size of 0.1 mg/kg. ED50 of propofol required for successful endoscope insertion was calculated by averaging the midpoints of all sequential crossovers. Using isotonic regression analysis, ED50 and ED95 (the effective doses required for successful gastroscope insertion in 95% of the subjects) were then extrapolated. All adverse events during painless GIE were recorded.
Results: Thirty patients were enrolled per group. Using MDUDM, the ED50 of propofol for successful gastroscope insertion was significantly lower in Group D (1.48 ± 0.10 mg/kg) than in Group S (1.82 ± 0.16 mg/kg; P < 0.001). The ED50 and ED95 of propofol were extrapolated to 1.80 mg/kg (83% confidence interval [CI], 1.649– 1.882) and 2.10 mg/kg (83% CI, 2.081– 2.124) for Group S, respectively, using isotonic regression analysis. These values were significantly lower in Group D, at 1.40 mg/kg (83% CI, 1.297– 1.452) and 1.70 mg/kg (83% CI, 1.667– 1.753).
Conclusion: Premedication with low-dose dexmedetomidine (0.3 μg/kg) significantly reduces the median effective doses of propofol required for successful gastroscope insertion during painless GIE.
Keywords: dexmedetomidine, propofol, effective dose, gastrointestinal endoscopy, sedation
1Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Anesthesiology, Maternal and Child Health Hospital of Henan Province, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 3Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fujian Provincial Hospital, Fuzhou, People’s Republic of China
Correspondence: Fu-Shan Xue, Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, NO. 95 Yong-An Road, Xi-Cheng District, Beijing, 100050, People’s Republic of China, Tel +86-13911177655, Email xuefushan@aliyun.com
Purpose: Patients undergoing painless gastrointestinal endoscopy (GIE) typically receive propofol-based sedation. However, the exact dose of propofol when combined with low-dose dexmedetomidine for this procedure remains unclear. The objective of this study was to determine and compare the median effective doses (ED50, the doses required for successful gastroscope insertion in 50% of the subjects) of propofol when used with low-dose dexmedetomidine (0.3 μg/kg) premedication versus propofol alone during painless GIE.
Patients and Methods: Adult outpatients aged 18 to 65 years scheduled for GIE were enrolled. Participants were randomized to receive either 0.9% saline (Group S) or 0.3 μg/kg of dexmedetomidine (Group D) intravenously over 5 min before induction with propofol. Using modified Dixon’s up-and-down method (MDUDM), the initial induction dose of propofol was 1.5 mg/kg, adjusted in a step size of 0.1 mg/kg. ED50 of propofol required for successful endoscope insertion was calculated by averaging the midpoints of all sequential crossovers. Using isotonic regression analysis, ED50 and ED95 (the effective doses required for successful gastroscope insertion in 95% of the subjects) were then extrapolated. All adverse events during painless GIE were recorded.
Results: Thirty patients were enrolled per group. Using MDUDM, the ED50 of propofol for successful gastroscope insertion was significantly lower in Group D (1.48 ± 0.10 mg/kg) than in Group S (1.82 ± 0.16 mg/kg; P < 0.001). The ED50 and ED95 of propofol were extrapolated to 1.80 mg/kg (83% confidence interval [CI], 1.649– 1.882) and 2.10 mg/kg (83% CI, 2.081– 2.124) for Group S, respectively, using isotonic regression analysis. These values were significantly lower in Group D, at 1.40 mg/kg (83% CI, 1.297– 1.452) and 1.70 mg/kg (83% CI, 1.667– 1.753).
Conclusion: Premedication with low-dose dexmedetomidine (0.3 μg/kg) significantly reduces the median effective doses of propofol required for successful gastroscope insertion during painless GIE.
Keywords: dexmedetomidine, propofol, effective dose, gastrointestinal endoscopy, sedation