Median effective dose of oliceridine as an adjunct to propofol sedation in patients with preclinical obesity undergoing same-visit bidirectional endoscopy

doi:10.12092/j.issn.1009-2501.2026.04.008

Abstract

Abstract:

AIM: To determine the median effective dose (ED₅₀) and 95% effective dose (ED₉₅) of oliceridine based on lean body weight (LBW) when combined with different propofol doses for same-visit bidirectional endoscopy in patients with preclinical obesity. METHODS: Fifty-four ASA physical status II–III preclinical obesity patients were randomized to receive propofol 2.0 mg/kg LBW (Group P1, n=28) or 2.5 mg/kg LBW (Group P2, n=26) combined with oliceridine (initial dose 0.02 mg/kg LBW, adjusted in ±0.005 mg/kg LBW increments). A positive response was defined as coughing or body movement ≥ grade 2 during gastroscopy (requiring procedure suspension or anesthetic deepening). The study terminated after observing seven crossover points (positive-to-negative response transitions). ED values were calculated using Probit regression analysis. Hemodynamics and adverse events were recorded. RESULTS: Patient demographics (gender, age, BMI, LBW) showed no intergroup differences. Based on LBW, the ED₅₀ and ED₉₅ of oliceridine in Group P1 were 0.037 mg/kg (95%CI: 0.033–0.042) and 0.048 mg/kg (95%CI: 0.043–0.075), respectively; in Group P2, the ED₅₀ and ED₉₅ were 0.012 mg/kg (95%CI: 0.004–0.016) and 0.023 mg/kg (95%CI: 0.017–0.063), respectively. Increasing propofol from 2.0 mg/kg to 2.5 mg/kg reduced oliceridine ED₅₀ by 52.1% and ED₉₅ by 67.6% (P<0.001), indicating synergism. Group P2 had lower incidence of respiratory depression (SpO₂ <90%: 30.8% vs. 46.4%) but higher rates of bradycardia (11.5% vs. 0%) and hypotension (15.4% vs. 3.6%) (all P>0.05). Injection pain (P1: 25.0% vs. P2: 26.9%) and recovery/discharge times did not differ significantly. No nausea, vomiting, or post-discharge adverse events occurred in either group. CONCLUSION: Propofol and oliceridine exhibit dose-dependent synergism. For preclinical obesity patients, propofol 2.5 mg/kg LBW combined with oliceridine 0.023 mg/kg LBW is recommended, providing effective anesthesia with reduced oliceridine requirements, lower respiratory depression risk, and satisfactory recovery.

Key words: oliceridine, propofol, preclinical obesity, same-visit bidirectional endoscopy, median effective dose

CLC Number:

R614.2

Yongjiu JI, Suli ZHOU, Siqi YANG, Yingzhou TU, Chenqi JIANG, Bingyuan ZHANG, Changmao ZHU, Qi ZHANG, Chun YANG, Suwan HU. Median effective dose of oliceridine as an adjunct to propofol sedation in patients with preclinical obesity undergoing same-visit bidirectional endoscopy[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(4): 493-499.

Figures/Tables 6

References 24

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Group	Sex (M/F)	ASA (Ⅱ/Ⅲ)	Age (years)	Oliceridine (mg)	TBW (kg)	LBW (kg)	BMI (kg/m²)	Propofol (mg)
P1 group (n=28)	21/7	18/10	46.5±11.2	2.1±0.5	84.4±11.2	58.9 (48.6,63.1)	28.9 (28.4,31.1)	195 (175,225)
P2 group (n=26)	15/11	20/6	45.6±11.2	0.7±0.3	82.4±8.9	58.2 (43.8,64.6)	28.5 (28.3,29.6)	215 (190,267.5)
x²/t/z	1.817	1.033	0.291	12.584	0.720	?0.580	?1.299	?1.448
P	0.250	0.379	0.773	＜0.001	0.474	0.562	0.194	0.148

Group	Sex (M/F)	ASA (Ⅱ/Ⅲ)	Age (years)	Oliceridine (mg)	TBW (kg)	LBW (kg)	BMI (kg/m²)	Propofol (mg)
P1 group (n=28)	21/7	18/10	46.5±11.2	2.1±0.5	84.4±11.2	58.9 (48.6,63.1)	28.9 (28.4,31.1)	195 (175,225)
P2 group (n=26)	15/11	20/6	45.6±11.2	0.7±0.3	82.4±8.9	58.2 (43.8,64.6)	28.5 (28.3,29.6)	215 (190,267.5)
x²/t/z	1.817	1.033	0.291	12.584	0.720	?0.580	?1.299	?1.448
P	0.250	0.379	0.773	＜0.001	0.474	0.562	0.194	0.148

Item	Time point	P1 group (n=13)	P2 group (n=14)	t/z	P
MAP (mmHg)	T0	110.2±11.4	109.1±14.9	0.226	0.823
	T1	85.9±9.1	89.1±11.7	?0.776	0.445
	T2	86.0±12.1	92.2±12.3	?1.318	0.199
	T3	87.1±8.8	93.8±13.7	?1.504	0.145
	T4	95.1±10.3	91.1±12.8	0.873	0.391
	T5	101.5±15.5	98.4±18.2	0.486	0.631
HR (bpm)	T0	78.9±10.7	75.9±12.0	0.680	0.503
	T1	81.1±7.8	81.6±8.4	?0.158	0.875
	T2	76.2±6.9	72.4±7.3	1.381	0.180
	T3	75.5±7.5	72.6±9.3	0.863	0.396
	T4	77.0±9.3	73.2±11.1	0.954	0.349
	T5	80.9±8.2	79.8±10.2	0.319	0.753
SpO₂ (%)	T0	98(97.5,100)	99.5(96.8,100)	?0.153	0.878
	T1	100(95,100)	100(99,100)	?1.457	0.145
	T2	98(96,99)	99(97.5,100)	?1.359	0.174
	T3	98(96,98.5)	99(97.5,100)	?1.797	0.072
	T4	96(94.5,98)	98(95.8,100)	?1.448	0.148
	T5	96(96,98.5)	96(94,97.3)	?0.812	0.417

Item	Time point	P1 group (n=13)	P2 group (n=14)	t/z	P
MAP (mmHg)	T0	110.2±11.4	109.1±14.9	0.226	0.823
	T1	85.9±9.1	89.1±11.7	?0.776	0.445
	T2	86.0±12.1	92.2±12.3	?1.318	0.199
	T3	87.1±8.8	93.8±13.7	?1.504	0.145
	T4	95.1±10.3	91.1±12.8	0.873	0.391
	T5	101.5±15.5	98.4±18.2	0.486	0.631
HR (bpm)	T0	78.9±10.7	75.9±12.0	0.680	0.503
	T1	81.1±7.8	81.6±8.4	?0.158	0.875
	T2	76.2±6.9	72.4±7.3	1.381	0.180
	T3	75.5±7.5	72.6±9.3	0.863	0.396
	T4	77.0±9.3	73.2±11.1	0.954	0.349
	T5	80.9±8.2	79.8±10.2	0.319	0.753
SpO₂ (%)	T0	98(97.5,100)	99.5(96.8,100)	?0.153	0.878
	T1	100(95,100)	100(99,100)	?1.457	0.145
	T2	98(96,99)	99(97.5,100)	?1.359	0.174
	T3	98(96,98.5)	99(97.5,100)	?1.797	0.072
	T4	96(94.5,98)	98(95.8,100)	?1.448	0.148
	T5	96(96,98.5)	96(94,97.3)	?0.812	0.417

Group	Injection pain	Nausea and vomiting	Hypotension	Bradycardia	Respiratory depression	PONV	Dizziness and falling
P1 group (n=28)	7(25)	0(0)	1(3.6)	0(0)	13(46.4)	1(3.6)	0(0)
P2 group (n=26)	7(26.9)	0(0)	4(15.4)	3(11.5)	8(30.8)	0(0)	0(0)
P	0.872	Untested	0.184	0.105	0.238	1.000	Untested