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

Background: Propofol is the most frequently administered intravenous anesthetic in painless gastroscopy. Oliceridine, a novel 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.