Effect of Dexmedetomidine on the ED₅₀ and ED₉₅ of Sufentanil in Patient-Controlled Intravenous Analgesia After Cesarean Section: A Randomized, Controlled, Double-Blind Trial.

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL Drug Design, Development and Therapy Pub Date : 2025-01-09 eCollection Date: 2025-01-01 DOI:10.2147/DDDT.S494162

Jiabei Li, Wuchang Fu, Na Wang, Sisi Zeng, Xuechao Li, Jixiang Wan, Fangjun Wang

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Abstract

Purpose: To determine the effect of dexmedetomidine on the ED₅₀ and ED₉₅ of sufentanil in patient-controlled intravenous analgesia (PCIA) after cesarean section.

Patients and methods: Parturients who underwent elective cesarean section (n = 80) were randomly assigned to either the sufentanil group (S group) or the dexmedetomidine-sufentanil combination group (DS group). Patients in the S group received a combination of sufentanil, 5 mg of tropisetron, and saline, whereas patients in the DS group were administered 1.5µg/kg of dexmedetomidine in addition to sufentanil, 5 mg of tropisetron, and saline. The ED₅₀ and ED₉₅ of sufentanil were determined by Dixon sequential method. We used probit regression to calculate the ED₅₀, ED₉₅, and 95% confidence intervals for sufentanil in each group.

Results: The ED₅₀ and ED₉₅ for sufentanil in the S group were 1.634 (95% CI: 1.476-1.810)µg/kg and 2.035 (95% CI: 1.841-3.312)µg/kg, respectively. The ED₅₀ and ED₉₅ for sufentanil in the DS group were 1.275 (95% CI: 1.187-1.353)µg/kg and 1.503 (95% CI: 1.406-1.824)µg/kg. The VAS scores with rest at t₅ and with movement at t₄- t₅ were lower in the DS group (P< 0.05). The t₂-t₅ Ramsay scores in the DS group were higher than those in the S group (P< 0.05). The doses of sufentanil and tramadol were markedly reduced in the DS group, while the onset of first lactation occurred significantly earlier in the DS group (P< 0.05). Compared with the S group, the DS group had a lower incidence of nausea, vomiting, and skin itching (P< 0.05), and lower frequency of patient-controlled analgesia (PCA) episodes (P< 0.05), and better postoperative pain satisfaction (P< 0.05).

Conclusion: The 1.5µg/kg dexmedetomidine can significantly decrease the ED₅₀ and ED₉₅ of sufentanil in patient-controlled intravenous analgesia after cesarean section, provide good postoperative analgesia and sedation, and promote the earlier occurrence of first lactation.

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右美托咪定对剖宫产术后患者静脉自控镇痛中舒芬太尼ED50和ED95的影响：一项随机、对照、双盲试验

目的：探讨右美托咪定对剖宫产术后患者自控静脉镇痛（PCIA）舒芬太尼ED50和ED95的影响。患者和方法：择期剖宫产的产妇（n = 80）随机分为舒芬太尼组（S组）和右美托咪定-舒芬太尼联合组（DS组）。S组患者接受舒芬太尼、5 mg托司司琼和生理盐水的联合治疗，而DS组患者在舒芬太尼、5 mg托司司琼和生理盐水的基础上给予1.5µg/kg右美托咪定。采用Dixon序列法测定舒芬太尼的ED50和ED95。我们使用probit回归计算各组舒芬太尼的ED50、ED95和95%置信区间。结果：S组舒芬太尼的ED50和ED95分别为1.634 （95% CI: 1.476 ~ 1.810）µg/kg和2.035 （95% CI: 1.841 ~ 3.312）µg/kg。DS组舒芬太尼的ED50和ED95分别为1.275 （95% CI: 1.187-1.353）µg/kg和1.503 （95% CI: 1.406-1.824）µg/kg。t5休息组和t4 ~ t5运动组VAS评分均低于DS组（P< 0.05）。DS组t2-t5 Ramsay评分高于S组（P< 0.05）。DS组舒芬太尼、曲马多剂量明显降低，首次泌乳时间明显提前（P< 0.05）。与S组相比，DS组恶心、呕吐、皮肤瘙痒发生率较低（P< 0.05），患者自控镇痛（PCA）发作次数较低（P< 0.05），术后疼痛满意度较好（P< 0.05）。结论：1.5µg/kg右美托咪定可显著降低剖宫产术后患者自控静脉镇痛中舒芬太尼的ED50和ED95，提供良好的术后镇痛镇静作用，促进首次泌乳提前发生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.