Trial reportDrug design, development and therapy2026
Dose-Finding of Alfentanil for Hysteroscopy Under Remimazolam Sedation in Obese and Normal-Weight Patients: An Up-and-Down Trial.
Trial report in Drug design, development and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
Background: Hysteroscopy is a minimally invasive procedure with rapid recovery. However, obesity may alter opioid pharmacokinetics and pharmacodynamics, and optimal alfentanil dosing remains uncertain. This study estimated the median effective dose (ED Methods: This was an up-and-down sequential allocation trial. Patients were classified as obese or normal-weight according to body mass index (BMI). Recruitment and dose allocation were conducted independently within each group until seven crossover pairs were obtained. Alfentanil was administered initially at 10 μg/kg, with subsequent doses adjusted using a 1 μg/kg step size according to the preceding patient's response. Remimazolam was administered as a 0.4 mg/kg bolus followed by infusion at 1 mg/kg/h, titrated to maintain a bispectral index (BIS) of 40-60. The ED50 was initially estimated using the modified Dixon up-and-down method, followed by probit regression to estimate model-derived ED Results: Sixty patients (31 normal-weight, 29 obese) were enrolled. Probit regression estimated an ED Conclusion: The total-body-weight (TBW)-normalized ED
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