Effects Of Different Doses Of Sufentanil On Propofol EC₅₀ In Patients With Vulvar Leukoplakia Treated With HIFU

Objective:To determine the propofol EC₅₀ of different doses of sufentanil in patients during HIFU treatment ofvulvar leukoplakia,and to evaluate the effects of different doses of sufentanil on propofol EC₅₀during HIFU treatment of vulvar leukoplakia,to provide a reference for clinical rational drug use.Method:A total of 60 patients scheduled forHIFU treatment of vulvar leukoplakia were selected from October 2021 to February 2022 in the affiliated Hospital of North Sichuan Medical College.All patients fasted routinely before the operation,and electrocardiogram（ECG）,non-invasive arterial blood pressure（NIBP）,and pulse oxygen saturation（SpO₂）were monitored routinely after entering the operating room.60 patients were randomly divided into 0.2μg/kg sufentanil group(S_0.2 group)and 0.3μg/kg sufentanil group(S_0.3 group).According to the grouping,sufentanil was injected intravenously followed by a target-controlled infusion of propofol（TCI）.The initial effect-site concentration of propofol in the first patient in each group was set to 2.5μg/mL.The operation began when the concentration in the effect room and plasma reached the set value and sufentanil was given for 3min.The HR and MAP of patients were recorded before induction of anesthesia（T₀）,at the time of sufentanil administration（T₁）,for 3min after sufentanil administration（T₂）,when the TCI effect chamber concentration and plasmaconcentration of propofol reached the set value（T₃）and for 5min after the operation（T₄）.Stop propofol infusion at the end of the operation.The adverse reactions during and after the operation,the quality of awakening（modified Aldrete score）,and the degree of pain（VAS score）were recorded.Propofol EC₅₀ and its 95%confidence interval（Confidence interval,CI）were determined by modifying Dixon’s up and downmethod,If the body movement（positive reaction）occurred during the operation,the concentration of propofol TCI in the next patient in this group increased 0.5μg/mL,otherwise decreased 0.5μg/mL.The experiment was ended when each group obtained 6 consecutive crossovers.Results:The EC₅₀ and 95%CI of propofol in the S₍0.2 group were 3.724 μg/mL（3.199～4.394 μg/mL）,and the EC₅₀ and 95%CI of propofol in S₍0.3 group were 3.626 μg/mL（2.658～4.912 μg/mL）.There was no significant difference in propofol EC₅₀ between the S_0.2 group and the S_0.3 group.Compared with the S_0.2 group,MAP at T₂ in the S_0.3 group decreased significantly（P<0.05）.The incidences of hypotension,respiratory depression,and bradycardia in S_0.2 group and S_0.3 group were 8.3%and 35.3%,8.3%and 23.5%,4.2%and 0.0%,respectively.The incidence of anesthesia-related complications in S_0.3 group was significantly higher than that in S_0.2 group（P<0.05）.There was a significant difference in the total incidence of complications between the S₍0.2 group and the S₍0.3 group（P<0.05）;There was no significant difference in the total amount of propofol,recovery time,recovery quality and pain degree between S_0.2 group and S_0.3 group（P>0.05）.Conclusion:The EC₅₀ of propofol in patients during HIFU treatment of vulvar leukoplakia was 3.724 μg/mL when given 0.2 μg/kg sufentanil.When sufentanil was increased to 0.3 μg/kg,there was no significant change in propofol EC₅₀,but the incidence of anesthesia-related complications increased significantly.Therefore,based on the results of this study,we recommend 0.2μg/kg sufentanil in the treatment of vulvar leukoplakia HIFU.