Determination of the median effective dose (ED₅₀) of oliceridine combined with propofol for inhibiting gastroscope insertion responses in adult patients undergoing painless gastroscopy

Abstract

Background Propofol is the most frequently administered intravenous anesthetic in painless gastroscopy. Oliceridine, a novel μ-opioid receptor agonist, exhibits analgesic effects while reducing adverse reactions. The combination of propofol and oliceridine has shown promising efficacy in clinical practice. However, the exploration of the specific effective dosage of oliceridine in painless gastroscopy is still in its early stages. This study aimed to determine the median effective dose (ED₅₀) of oliceridine when combined with propofol during painless gastroscopy. Methods Patients aged 18–85 years with American Society of Anesthesiologists (ASA) physical status I to III undergoing painless gastroscopy were enrolled. They received an intravenous injection of oliceridine, followed by propofol at a dose of 1.5 mg/kg. The initial dose of oliceridine for the first patient was 20 μg/kg, and subsequent doses were adjusted using Dixon’s up-and-down method based on the previous patient’s response to gastroscope insertion—with a 1 μg/kg increase or decrease depending on the observed response. Data collection continued until 7 crossover points were obtained. Probit regression and bootstrapping methods were used to calculate the ED₅₀ and its 95% confidence intervals (CI). Hemodynamic parameters and perioperative adverse events were recorded. Results A total of 24 patients were included in the study. The ED₅₀ of oliceridine combined with propofol (1.5 mg/kg) for inhibiting the response to gastroscope insertion in patients undergoing painless gastroscopy was 19.33 μg/kg (95% CI, 17.41 ~ 21.98 μg/kg). The vital signs of all patients remained within the predefined acceptable limits, and no serious adverse events occurred. Conclusion The ED₅₀ of oliceridine combined with propofol (1.5 mg/kg) for inhibiting gastroscope insertion responses in adult patients undergoing painless gastroscopy is 19.33 μg/kg. Clinical trials registration ChiCTR2500105523.