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| 饮酒对环泊酚用于无痛胃肠镜检查时半数有效剂量的影响 |
| Effect of alcohol consumption on median effective dose of ciprofol in painless gastrointestinal endoscopy |
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| DOI：10.12089/jca.2025.07.010 |
| 中文关键词: 环泊酚 无痛胃肠镜检查 饮酒 剂量-效应关系 |
| 英文关键词: Ciprofol Painless gastrointestinal endoscopy Alcohol drinking Dose-effect relationship |
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| 中文摘要: |
目的：探讨饮酒对环泊酚用于无痛胃肠镜检查患者麻醉镇静半数有效剂量（ED50）及95%有效剂量（ED95）的影响。
方法：选择择期行无痛胃肠镜检查的男性患者51例，年龄18～74岁，BMI 18.5～30.0 kg/m2，ASAⅠ或Ⅱ级。根据饮酒情况将患者分为两组：饮酒组（n=26）和非饮酒组（n=25）。饮酒组患者饮酒史10年以上，且近一年单次最大饮酒量不少于80 g乙醇；非饮酒组从不饮酒。麻醉镇静时静脉注射环泊酚，待药物输注完毕3 min后改良警觉/镇静评分（MOAA/S）≤1分且BIS降至≤60，进行胃肠镜检查。采用改良Dixon序贯法进行试验，环泊酚初始剂量为0.5 mg/kg，剂量梯度为0.05 mg/kg，根据上一例患者的阳性或阴性反应而升高或降低1个剂量梯度，阳性反应定义为：首次输注环泊酚完毕3 min后MOAA/S评分>1分且BIS＞60，或置入胃镜1 min内出现体动、呛咳、吞咽等反应。当阴性反应和阳性反应交替形成8个拐点时结束试验。采用Probit概率回归法分别计算环泊酚用于无痛胃肠镜麻醉镇静的ED50、ED95和95%可信区间（CI）。记录苏醒时间和离室时间。
结果：饮酒组环泊酚用于无痛胃肠镜检查麻醉镇静的ED50为0.431 mg/kg（95%CI 0.397～0.460 mg/kg），ED95为0.494 mg/kg（95%CI 0.464～0.650 mg/kg）；非饮酒组环泊酚用于无痛胃肠镜麻醉镇静的ED50为0.378 mg/kg（95%CI 0.342～0.407 mg/kg），ED95为0.437 mg/kg（95%CI 0.408～0.596 mg/kg）。与非饮酒组比较，饮酒组ED50明显升高，苏醒时间和离室时间明显缩短（P＜0.05）。
结论：长期饮酒降低环泊酚用于无痛胃肠镜患者的镇静效力，在对此类患者行无痛胃肠镜检查时可能需要适当增加环泊酚的用量。 |
| 英文摘要: |
Objective: To investigate the effect of alcohol consumption on the median effective dose (ED50) and 95% effective dose (ED95) of ciprofol for sedation induction in patients undergoing painless gastrointestinal endoscopy.
Methods: Fifty-one male patients scheduled for elective painless gastrointestinal endoscopy were selected, aged 18-74 years, BMI 18.5-30.0 kg/m2, ASA physical status Ⅰ or Ⅱ. The patients were divided into two groups according to their drinking conditions: drinking group (n = 26) and non-drinking group (n = 25). The drinking group consisted of individuals with a history of alcohol consumption exceeding 10 years, and a maximum single alcohol intake of no less than 80 grams of ethanol within the past year. The non-drinking group never drank alcohol. For anesthetic sedation, ciprofol was administered intravenously. Gastrointestinal endoscopy was performed 3 minutes after the completion of drug infusion, when the modified observer's assessment of alertness/sedation (MOAA/S) score was ≤ 1 score and the patient's BIS value had decreased to 60 or below. The study employed the modified Dixon's up-and-down sequential method, with an initial ciprofol dose of 0.5 mg/kg and a dose gradient of 0.05 mg/kg. The dose was adjusted based on the positive or negative response of the previous patient. The positive response was defined as MOAA/S score > 1 score and BIS > 60, or the occurrence of body movement, coughing, or swallowing within 1 minute of gastroscopy insertion after the first ciprofol infusion. The trial was concluded when 8 crossover points were formed by alternating negative and positive responses. The Probit probability regression method was used to calculate the ED50 and ED95 with corresponding 95% confidence interval (CI) of ciprofol for sedation induction in painless gastrointestinal endoscopy in both patient groups.
Results: In the drinking group, the ED50 and ED95 of ciprofol were 0.431 mg/kg (95% CI 0.397-0.460 mg/kg) and 0.494 mg/kg (95% CI 0.464-0.650 mg/kg), respectively. In the non-drinking group, the ED50 and ED95 of ciprofol were 0.378 mg/kg (95% CI 0.342-0.407 mg/kg) and 0.437 mg/kg (95% CI 0.408-0.596 mg/kg), respectively. Compared with the non-drinking group, the ED50 in the drinking group was significantly higher, and the recovery time and time to discharge from the recovery room were significantly shorter (P < 0.05).
Conclusion: Long-term alcohol consumption diminishes the sedative efficacy of ciprofol, it may be necessary to appropriately increase the dosage of ciprofol in patients undergoing painless gastrointestinal endoscopy. |
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