The median effective dose of propofol combined with butorphanol during artificial abortion: a randomized controlled trial

Yuling Zheng; Jinping Huang; Ying Mai; Xiaoling Li; Zhongqi Zhang

doi:10.3389/fmed.2023.1226495

The median effective dose of propofol combined with butorphanol during artificial abortion: a randomized controlled trial

Front Med (Lausanne). 2023 Nov 27:10:1226495. doi: 10.3389/fmed.2023.1226495. eCollection 2023.

Authors

Yuling Zheng^#¹, Jinping Huang^#², Ying Mai¹, Xiaoling Li¹, Zhongqi Zhang¹

Affiliations

¹ Department of Anesthesiology, The Affiliated Shunde Hospital of Jinan University, Foshan, China.
² Department of Anesthesiology, The Seventh Affiliated Hospital of Southern Medical University, Foshan, China.

^# Contributed equally.

Abstract

Objective: Propofol-opioids are the most common drug combination and can reduce the dose of propofol and the incidence of adverse events in painless artificial abortion. We hypothesized that butorphanol may reduce the median effective dose (ED₅₀) of propofol, propofol injection pain, and postoperative uterine contraction pain.

Methods: This was a randomized, double-blind, controlled study. A total of 54 female patients, who had ASA I or II, aged 18-49 years, undergoing painless artificial abortion, were randomly assigned into two groups, namely, Group P (propofol) and Group PB (propofol plus 10 μg/kg butorphanol). According to the pre-experiment, the initial dose of propofol for the P and PB groups was 3 and 2.5 mg/kg, respectively, with a dose gradient of 0.25 mg/kg. The ED₅₀ of propofol was analyzed using probit regression analysis. The total propofol dose consumed, recovery time, and anesthesia-related adverse events were also recorded.

Results: There were 25 and 29 patients in the P and PB groups, respectively. The ED₅₀ (95% CI) of propofol for artificial abortion were 2.477 (2.186-2.737) and 1.555 (1.173-1.846) mg/kg in the P and PB groups, respectively. The total propofol dose consumed was (150.7 ± 21.7) mg and (110.4 ± 28.2) mg in the P and PB groups, respectively (P < 0.001). Compared with the P group, injection-site pain (76 vs. 20.7%) and uterine contraction pain (72 vs. 6.9%) in the PB group had a significant decrease (P < 0.001).

Conclusion: Combination of propofol with 10 μg/kg butorphanol reduced the ED₅₀ of propofol and decreased the incidence of propofol injection-site pain and postoperative uterine contraction pain during painless artificial abortion compared with propofol alone.

Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=166610, identifier: ChiCTR2200059795.

Keywords: butorphanol; median effective dose; painless abortion; propofol; up-and-down method.

Grants and funding

Medical Scientific Research Project of Foshan Municipal Health Bureau, Number: 20230823A010458; Foshan Self-funded Science and Technology Innovation Project, Number: 2220001003819; Key Medical Talents Training Project of Shunde District; Medical Science and Technology Research Foundation of Guangdong Province, Number: A2022515.