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ORIGINAL ARTICLE
Year : 2018  |  Volume : 131  |  Issue : 16  |  Page : 1958-1963

Gender Affects the Median Effective Dose and 95% Effective Dose of Oxycodone for Blunting the Hemodynamic Response to Tracheal Intubation in Narcotic-Naïve Adult Patients


1 Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
2 Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003; Department of Anesthesiology, Changxing Hospital of Traditional Chinese Medicine, Changxing County, Huzhou, Zhejiang 313100, China

Correspondence Address:
Dr. Sheng-Mei Zhu
Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang 310003
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.238138

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Background: Intravenous (IV) oxycodone has been used at induction to prevent an intubation reaction. The aims of the current study were to calculate the median effective dose (ED50) and the 95% effective dose (ED95) of an IV bolus of oxycodone that blunts the hemodynamic response to tracheal intubation with propofol according to gender and to observe the adverse events of induction-dose oxycodone. Methods: Adult patients who required general anesthesia and tracheal intubation were enrolled. Tracheal intubation was performed using unified TD-C-IV video laryngoscopy and an ordinary common endotracheal tube. Dixon's up-and-down method was used to obtain ED50data for women and men separately. The initial dose of oxycodone was 0.2 mg/kg for women and 0.3 mg/kg for men (step size was 0.01 mg/kg). Next, a dose-response curve from the probit analysis was generated to determine the ED50and ED95to blunt the intubation reaction in female and male patients. Adverse events following oxycodone injection were observed for 5 min before propofol injection. Results: Sixty-three patients were analyzed, including 29 females and 34 males. According to the probit analysis, the ED50 and ED95of oxycodone required to blunt the intubation reaction in women were 0.254 mg/kg (95% confidence interval [CI], 0.220–0.328 mg/kg) and 0.357 mg/kg (95% CI, 0.297–2.563 mg/kg), respectively. In men, the ED50 and ED95were 0.324 mg/kg (95% CI, 0.274–0.381 mg/kg) and 0.454 mg/kg (95% CI, 0.384–2.862 mg/kg), respectively. Men required 28% more oxycodone than women for induction (P < 0.01). The most common adverse events were dizziness (87.3%), vertigo (66.7%), sedation (74.6%), and respiratory depression (66.7%). Conclusions: Oxycodone can be used for induction to prevent intubation reactions. Gender affected the ED50and ED95of oxycodone for blunting the tracheal intubation reaction.

 

 Abstract in Chinese

性别影响羟考酮抑制成人患者气管插管血流动力学变化的ED50ED95

摘要

背景:静脉注射羟考酮已在临床上用于预防气管插管反应。本研究的目的是计算在联合应用丙泊酚诱导时,不同性别静脉注射羟考酮抑制气管插管的血流动力学变化的50%有效剂量(ED50)和95%有效剂量(ED95),并观察应用羟考酮诱导剂量的不良反应。

方法:研究对象是成人需要全身麻醉和气管插管的患者。气管插管采用统一的TD-C-IV型可视喉镜和普通的气管插管。应用Dixon«SQ»s的上下方分别计算男性和女性的ED50。羟考酮的初始剂量为0.2 mg/kg女性和0.3 mg/kg男性(相邻剂量组梯度为0.01 mg/kg)。男女组各自出现7个阳性到阴性反应交叉点后结束实验,应用probit分析拟合剂量-效应曲线获取得抑制女性和男性患者气管插管反应的ED50和ED95及和95%可信区间。羟考酮注射5分钟后静注丙泊酚和罗库溴铵完成诱导,观察5分钟内羟考酮不良反应。

结果:共有63名患者纳入分析,其中女性29例,男性34例。根据probit分析,羟考酮抑制女性插管反应的ED50和ED95分别为0.254 mg/kg(95%可信区间[CI],0.220~0.328 mg/kg)和0.357 mg/kg(95% CI,0.297~2.563 mg/kg)。男性ED50和ED95分别为0.324 mg/kg(95% CI,0.274~0.381 mg/kg)和0.454 mg/kg(95% CI,0.384~2.862 mg/kg)。男性比女性的羟考酮诱导的ED50> 28%(P<0.01)。最常见的不良反应为眩晕(87.3%)、视物旋转(66.7%)、镇静(74.6%)和呼吸抑制(66.7%)。

结论:羟考酮可用于诱导,以预防气管插管反应。性别影响羟考酮抑制插管反应的ED50和ED95。



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