Objective To explore the median effective dose of propofol or cyclopofol combined with alfentanil in inhibiting body movement response during induced abortion.Methods From October 2021 to April 2022,patients aged 18-35 years,body mass index(BMI)18-28 kg/m2,American Society of Anesthesologists(ASA)I or II,fetal age<10 weeks,first pregnancy or no history of vaginal delivery were selected for elective painless induced abortion in Gynecological Surgery Center of the Second Hospital of Jiaxing.Patients were divided into 2 groups using a random number table method:propofol group(group P)and cyclopofol group(group C).During anesthesia induction,intravenous injection of alfentanil was followed by administration of propofol or cyclopofol with a dose set by the modified sequential method.If the patient had involuntary limb movement during surgery and affected the operation of the operator and needed additional anesthetic drugs,it was judged as a positive reaction,and intravenous propofol or cyclopofol 0.5mg/kg or 0.1mg/kg was added,and the next patient's propofol or cyclopofol was increased by a dose gradient.Conversely,the next patient was given a dose gradient of 0.5mg/kg propofol or 0.1mg/kg cyclopofol,respectively.Probit regression analysis was used to calculate the median effective dose(ED50),95%effective dose(ED95)and corresponding confidence interval(CI)of propofol and cyclopofol.Results The ED50(95%CI)and ED95(95%CI)of propofol in group P were 1.815(1.315-2.319)mg/kg and 2.901(2.368-6.447)mg/kg,respectively.The ED50(95%CI)and ED95(95%CI)of cyclopofol in group C were 0.381(0.279-0.484)mg/kg and 0.613(0.501-1.344)mg/kg,respectively,and the equivalent ratio of the two was 4.76(4.71-4.79).Conclusion The potency of ciprofol in inhibiting movement response during induced abortion is greater than that of propofol.

Objective:To evaluate the effect of lidocaine on the dose-effect relationship of remimazolam combined with alfentanil in inhibiting responses to gastroscope insertion in elderly patients.Methods:American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱelderly patients of either sex, aged 65-80 yr, with body mass index of 18-28 kg/m 2, undergoing painless gastroscopy under general anesthesia, were divided into 2 groups using a random number table method: remimazolam group (group C) and lidocaine combined with remimazolam group (group L). Alfentanil 6 μg/kg was given at anesthesia induction in all the patients, and then lidocaine 2 mg/kg was intravenously injected in the patients in group L. Modified Dixon′s up-and-down method was used for the study. Remimazolam was intravenously injected at a dose of 0.18 mg/kg in the first patient, and the gastroscope was placed when the eyelash reflex disappeared and the modified observational alertness/sedation assessment score ≤3. Gastroscope insertion response was defined as swallowing, bucking, body movement and other responses affecting the quality of examination during the gastroscope insertion. The dose of remimazolam was increased/decreased by 0.02 mg/kg in the next patient if the gastroscope response was positive or negative, and the process was repeated until 9 turning points occurred. The median effective dose (ED 50) and 95% confidence interval ( CI) of remimazolam were calculated by probit method. Results:The ED 50 (95% CI) of remidazolam in inhibiting responses to gastroscope insertion in elderly patients when combined with alfentanil was 0.158 (0.133-0.183) mg/kg in group C. The ED 50 (95% CI) of remidazolam in inhibiting responses to gastroscope insertion in elderly patients when combined with fentanyl was 0.139 (0.127-0.151) mg/kg in group L. The ED 50 was significantly lower in group L than in group C ( P=0.003). Conclusions:Intravenous lidocaine in combination with alfentanil increases the efficacy of remimazolam for painless gastroscopy in elderly patients.