Determining the Effective Dose of Oliceridine Compounded with Propofol for Painless Hysteroscopy: A Prospective...

Oliceridine combined with propofol is suitable for intravenous anesthesia in painless hysteroscopy. This study aimed to determine the 50% effective dose (ED₅₀) and 95% effective dose (ED₉₅) of oliceridine compounded with propofol for painless hysteroscopy.

In all, 29 patients aged 18-60 years who were scheduled for painless hysteroscopy under intravenous anesthesia were recruited, and a total of 26 patients were enrolled in the final analysis. The trial was conducted using the modified Dixon sequential method, with an initial dose of 1.5 mg of oliceridine, followed by 2.0-2.5 mg/kg of propofol administered 1 minute later. Whether the dose of oliceridine was increased or decreased depends on the prior operation. If the hysteroscopy failed (positive response), which was defined as inadequate cervical dilatation, patient body movements, frowning, heart rate (HR), or mean arterial pressure (MAP) greater than 20% of the baseline value, or a MOAA/S score ≥ 2, the subsequent dosage of oliceridine was increased by 0.1 mg. Conversely, the dose was decreased by 0.1 mg. At least seven crossover waves had to occur before the formal test was stopped. The probit regression method was used to determine the ED₅₀ and ED₉₅ with 95% confidence intervals (CIs).

The ED₅₀ and ED₉₅ of oliceridine in patients were 1.583 (95% CIs: 1.444-1.857) mg and 1.848 (95% CIs: 1.701-4.409) mg, respectively.

A dose of 1.848 mg oliceridine compounded with propofol provides an effective anesthesia approach for painless hysteroscopy. Future larger, multicenter studies will help to expand the population range of oliceridine use and explore its potential benefits and risks.