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Randomized Controlled Trial
. 2025 Apr 24:19:3129-3138.
doi: 10.2147/DDDT.S508736. eCollection 2025.

Optimal Effect-Site Concentration of Propofol for Hemodynamic Stability During Intubation with Dexmedetomidine: A Randomized Controlled Study

Huayuan Gao #  1 , Junmei Wu #  1 , Youwen Chen #  1 , Chengyu Wang  2 , Minmin Yao  2 , Yan Yang  2 , Changhong Miao #  2 , Chao Liang #  2
Affiliations
Randomized Controlled Trial

Optimal Effect-Site Concentration of Propofol for Hemodynamic Stability During Intubation with Dexmedetomidine: A Randomized Controlled Study

Huayuan Gao et al. Drug Des Devel Ther. .

Abstract

Background: This study aimed to determine the 95% effective concentration (EC95) of propofol via target-controlled infusion (TCI) for endotracheal intubation at three different doses of dexmedetomidine.

Methods: One hundred and eighty patients aged 18-60 and classified as American Society of Anesthesiologists (ASA) class I-II were enrolled to undergo general anesthesia. Patients were randomly assigned to one of the three groups (A, B, or C), receiving three different doses of dexmedetomidine (0.6, 0.8, or 1 μg/kg) infused over 10 min. Anesthesia was then induced with propofol TCI, followed by rocuronium. The biased coin design method was used to calculate the EC95 of propofol for successful intubation. The primary outcome endpoint was the EC95 of propofol for successful endotracheal intubation at each dexmedetomidine dose.

Results: Sixty patients in each group completed the trial. The time from propofol administration to intubation in group C (132.5 ± 10.7 s) was significantly shorter compared to group A (140.2 ± 14.4 s, P<0.0001) and group B (142.6 ± 13.2 s, P=0.0037). Both the EC95 and the average total dose of propofol in group B [14.6 (10.8, 14.8) μg/mL and 3.6 ± 1.1 mg/kg] and C [12.7 (11.5, 12.8) μg/mL and 2.8 ± 1.0 mg/kg] were lower than those in group A [14.9 (4.5, 15.0) μg/mL and 3.8 ± 0.9 mg/kg] (P<0.001). The incidence of hypotension and bradycardia during induction was low in each group.

Conclusion: The EC95 of propofol for endotracheal intubation across three different background doses of dexmedetomidine was determined. We suggest administering 1.0 μg/kg dexmedetomidine and then the EC95 of propofol for successful endotracheal intubation was 12.7 μg/mL.

Registration: Chinese Clinical Trial Registry; Registration number: ChiCTR2400089952, URL:https://www.chictr.org.cn/showproj.html?proj=221236.

Keywords: dexmedetomidine; effective concentration; endotracheal intubation; opioid-free anesthesia; propofol.

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Conflict of interest statement

The authors disclose no conflicts of interest with respect to this work.

Figures

Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
(A-C) The positive or negative reaction for each participant at the designated dosage of dexmedetomidine, with the participant sequence on the x-axis and each allocated dosage on the y-axis, respectively.
Figure 3
Figure 3
The HR (A), MAP (B), and BIS (C) values at T0, T1, T2, T3, T4, and T5 in three groups. T0: before administering dexmedetomidine, T1: before anesthesia induction, T2: before tracheal intubation, T3: during tracheal intubation, T4: after tracheal intubation, T5: 3 minutes after tracheal intubation. No significant differences (P>0.05) in HR, MAP and BIS values were observed at these time points in the three groups.
See this image and copyright information in PMC

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