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Determination of the ED(95 )of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography

BACKGROUND: Sedation during endoscopic ultrasonography (EUS) poses many challenges and moderate-to-deep sedation are often required. The conventional method to preform moderate-to-deep sedation is generally intravenous benzodiazepine alone or in combination with opioids. However, this combination ha...

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Autores principales: Zou, Yi, Li, Na, Shao, Liu-Jia-Zi, Liu, Fu-Kun, Xue, Fu-Shan, Tao, Xing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8968820/
https://www.ncbi.nlm.nih.gov/pubmed/35434098
http://dx.doi.org/10.12998/wjcc.v10.i9.2773
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author Zou, Yi
Li, Na
Shao, Liu-Jia-Zi
Liu, Fu-Kun
Xue, Fu-Shan
Tao, Xing
author_facet Zou, Yi
Li, Na
Shao, Liu-Jia-Zi
Liu, Fu-Kun
Xue, Fu-Shan
Tao, Xing
author_sort Zou, Yi
collection PubMed
description BACKGROUND: Sedation during endoscopic ultrasonography (EUS) poses many challenges and moderate-to-deep sedation are often required. The conventional method to preform moderate-to-deep sedation is generally intravenous benzodiazepine alone or in combination with opioids. However, this combination has some limitations. Intranasal medication delivery may be an alternative to this sedation regimen. AIM: To determine, by continual reassessment method (CRM), the minimal effective dose of intranasal sufentanil (SUF) when combined with intranasal dexmedetomidine (DEX) for moderate sedation of EUS in at least 95% of patients (ED(95)). METHODS: Thirty patients aged 18-65 and scheduled for EUS were recruited in this study. Subjects received intranasal DEX and SUF for sedation. The dose of DEX (1 μg/kg) was fixed, while the dose of SUF was assigned sequentially to the subjects using CRM to determine ED(95). The sedation status was assessed by modified observer’s assessment of alertness/sedation (MOAA/S) score. The adverse events and the satisfaction scores of patients and endoscopists were recorded. RESULTS: The ED(95 )was intranasal 0.3 μg/kg SUF when combined with intranasal 1 μg/kg DEX, with an estimated probability of successful moderate sedation for EUS of 94.9% (95% confidence interval: 88.1%-98.9%). When combined with intranasal 1 μg/kg DEX, probabilities of successful moderate sedation at each dose level of intranasal SUF were as follows: 0 μg/kg SUF, 52.8%; 0.1 μg/kg SUF, 75.4%; 0.2 μg/kg SUF, 89.9%; 0.3 μg/kg SUF, 94.9%; 0.4 μg/kg SUF, 98.0%; 0.5 μg/kg SUF, 99.0%. CONCLUSION: The ED(95 )needed for moderate sedation for EUS is intranasal 0.3 μg/kg SUF when combined with intranasal 1 μg/kg DEX, based on CRM.
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spelling pubmed-89688202022-04-14 Determination of the ED(95 )of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography Zou, Yi Li, Na Shao, Liu-Jia-Zi Liu, Fu-Kun Xue, Fu-Shan Tao, Xing World J Clin Cases Clinical Trials Study BACKGROUND: Sedation during endoscopic ultrasonography (EUS) poses many challenges and moderate-to-deep sedation are often required. The conventional method to preform moderate-to-deep sedation is generally intravenous benzodiazepine alone or in combination with opioids. However, this combination has some limitations. Intranasal medication delivery may be an alternative to this sedation regimen. AIM: To determine, by continual reassessment method (CRM), the minimal effective dose of intranasal sufentanil (SUF) when combined with intranasal dexmedetomidine (DEX) for moderate sedation of EUS in at least 95% of patients (ED(95)). METHODS: Thirty patients aged 18-65 and scheduled for EUS were recruited in this study. Subjects received intranasal DEX and SUF for sedation. The dose of DEX (1 μg/kg) was fixed, while the dose of SUF was assigned sequentially to the subjects using CRM to determine ED(95). The sedation status was assessed by modified observer’s assessment of alertness/sedation (MOAA/S) score. The adverse events and the satisfaction scores of patients and endoscopists were recorded. RESULTS: The ED(95 )was intranasal 0.3 μg/kg SUF when combined with intranasal 1 μg/kg DEX, with an estimated probability of successful moderate sedation for EUS of 94.9% (95% confidence interval: 88.1%-98.9%). When combined with intranasal 1 μg/kg DEX, probabilities of successful moderate sedation at each dose level of intranasal SUF were as follows: 0 μg/kg SUF, 52.8%; 0.1 μg/kg SUF, 75.4%; 0.2 μg/kg SUF, 89.9%; 0.3 μg/kg SUF, 94.9%; 0.4 μg/kg SUF, 98.0%; 0.5 μg/kg SUF, 99.0%. CONCLUSION: The ED(95 )needed for moderate sedation for EUS is intranasal 0.3 μg/kg SUF when combined with intranasal 1 μg/kg DEX, based on CRM. Baishideng Publishing Group Inc 2022-03-26 2022-03-26 /pmc/articles/PMC8968820/ /pubmed/35434098 http://dx.doi.org/10.12998/wjcc.v10.i9.2773 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Clinical Trials Study
Zou, Yi
Li, Na
Shao, Liu-Jia-Zi
Liu, Fu-Kun
Xue, Fu-Shan
Tao, Xing
Determination of the ED(95 )of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography
title Determination of the ED(95 )of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography
title_full Determination of the ED(95 )of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography
title_fullStr Determination of the ED(95 )of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography
title_full_unstemmed Determination of the ED(95 )of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography
title_short Determination of the ED(95 )of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography
title_sort determination of the ed(95 )of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography
topic Clinical Trials Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8968820/
https://www.ncbi.nlm.nih.gov/pubmed/35434098
http://dx.doi.org/10.12998/wjcc.v10.i9.2773
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