Optimal Effect-Site Concentration of Propofol for Hemodynamic Stability During Intubation with Dexmedetomidine: A...

This study aimed to determine the 95% effective concentration (EC₉₅) of propofol via target-controlled infusion (TCI) for endotracheal intubation at three different doses of dexmedetomidine.

One hundred and eighty patients aged 18-60 and classified as American Society of Anesthesiologists (ASA) class I-II were enrolled to undergo general anesthesia. Patients were randomly assigned to one of the three groups (A, B, or C), receiving three different doses of dexmedetomidine (0.6, 0.8, or 1 μg/kg) infused over 10 min. Anesthesia was then induced with propofol TCI, followed by rocuronium. The biased coin design method was used to calculate the EC₉₅ of propofol for successful intubation. The primary outcome endpoint was the EC₉₅ of propofol for successful endotracheal intubation at each dexmedetomidine dose.

Sixty patients in each group completed the trial. The time from propofol administration to intubation in group C (132.5 ± 10.7 s) was significantly shorter compared to group A (140.2 ± 14.4 s, P<0.0001) and group B (142.6 ± 13.2 s, P=0.0037). Both the EC₉₅ and the average total dose of propofol in group B [14.6 (10.8, 14.8) μg/mL and 3.6 ± 1.1 mg/kg] and C [12.7 (11.5, 12.8) μg/mL and 2.8 ± 1.0 mg/kg] were lower than those in group A [14.9 (4.5, 15.0) μg/mL and 3.8 ± 0.9 mg/kg] (P<0.001). The incidence of hypotension and bradycardia during induction was low in each group.

The EC₉₅ of propofol for endotracheal intubation across three different background doses of dexmedetomidine was determined. We suggest administering 1.0 μg/kg dexmedetomidine and then the EC₉₅ of propofol for successful endotracheal intubation was 12.7 μg/mL.

Chinese Clinical Trial Registry; Registration number: ChiCTR2400089952, URL:https://www.chictr.org.cn/showproj.html?proj=221236.