ED50 and ED95 of Nalbuphine Combined with Ciprofol in Laryngeal Mask Insertion Responses in Day-Patient Hysteroscopic Surgery

Abstract

Objective: This study aimed to determine the effective dose (ED₅₀ and ED₉₅) of ciprofol combined with nalbuphine in inhibiting laryngeal mask insertion responses in day-patients hysteroscopic surgery using a sequential method. Methods: Patients undergoing general anesthesia hysteroscopic in a daytime surgery center were selected. The age of patients ranged from 18 to 60 years, BMI ranged from 18.0 to 28.0 kg/m ², and ASA classification ranged from gradeⅠto gradeⅡ. Nalbuphine was administered via slow intravenous injection at an initial dose of 0.16 mg/kg, followed by intravenous administration of 0.4 mg/kg ciprofol. The laryngeal mask was inserted when the patient’s eyelash reflex disappeared and the Narcotrend index reached between 50 and 60. A sequential method was employed to establish the nalbuphine dosage: if a positive response occurred during laryngeal mask insertion, the next patient received a dose one gradient higher; conversely, if no response was observed, a lower dose one gradient down was chosen, with adjacent dose differences of 0.01 mg/kg. The ED₅₀ and ED₉₅ of ciprofol combined with nalbuphine for inhibiting laryngeal mask insertion responses were calculated along with their respective 95% confidence intervals (CIs). Results: The ED₅₀ value of nalbuphine for inhibiting laryngeal mask insertion responses was found to be 0.149 mg/kg (95% CI: 0.142–0.155 mg/kg), while the ED₉₅ value was determined to be 0.160 mg/kg (95% CI: 0.154–0.191 mg/kg).Conclusion: When combined with ciprofol, the ED₅₀ of nalbuphine for inhibiting laryngeal mask insertion responses in patients undergoing outpatient hysteroscopic surgery is established at 0.149 mg/kg (95% CI: 0.142–0.155 mg/kg), and the ED₉₅ is set at 0.160 mg/kg (95% CI: 0.154–0.191 mg/kg).