Pump-Predicted Ciprofol Ce50 for Suppressing the Cardiovascular Response to Tracheal Intubation During Fixed Sufentanil–Esketamine Induction: An Age-Stratified Dixon Up-and-Down Study
- 1Department of Anesthesiology, The Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, People’s Republic of China
Abstract
Purpose: To estimate the ciprofol pump-predicted effect-site target concentration associated with a 50% probability of suppressing the cardiovascular response to tracheal intubation (Ce50) during fixed sufentanil-esketamine induction in two age cohorts.
Patients and Methods: In this single-center, prospective, age-stratified Dixon up-and-down study, 53 adults undergoing elective surgery received sufentanil 0.3 μg/kg, esketamine 0.3 mg/kg, and ciprofol effect-site target-controlled infusion (TCI). Independent cohorts aged 45–64 and 65–79 years started at a pump-predicted target concentration (Ce) of 1.10 μg/mL, adjusted in 0.05 μg/mL steps. Ce50 was estimated by reversal-pair midpoints and Probit analysis. The trial was registered on March 31, 2026 (ChiCTR2600121464).
Results: Thirty-two middle-aged and 21 older adults were analyzed. Midpoint Ce50 was 0.975 μg/mL (approximate 95% confidence interval [CI], 0.910–1.040) and 1.096 μg/mL (1.072–1.121), respectively. Probit Ce50 was 0.991 μg/mL (95% CI, 0.773–1.103) and 1.112 μg/mL (1.078–1.152). At target Ce, mean arterial pressure fell by 19.2% ± 11.0% and 22.5% ± 12.5% from baseline. Hypotension occurred in 20/32 (62.5%) and 13/21 (61.9%) participants.
Conclusion: These exploratory Ce50 estimates are specific to the CONCERT-III pump model and the studied co-induction and rescue protocol in small, nonrandomized cohorts at a single center. Frequent hypotension and norepinephrine use accompanied induction. The estimates do not establish an independent age effect or individual dosing targets and require external validation.
Trial Registration: Chinese Clinical Trial Registry, ChiCTR2600121464; prospectively registered March 31, 2026.
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BibTeX
@article{lin2026pumppredicted,
title = {{Pump-Predicted Ciprofol Ce50 for Suppressing the Cardiovascular Response to Tracheal Intubation During Fixed Sufentanil–Esketamine Induction: An Age-Stratified Dixon Up-and-Down Study}},
author = {Xiaofen Lin and Qing Wan and Ruwen Huang and Rui Li and Mengrong Hu},
journal = {Drug Design, Development and Therapy},
year = {2026},
month = nov,
doi = {10.2147/dddt.s658705},
url = {https://doi.org/10.2147/dddt.s658705},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Pump-Predicted Ciprofol Ce50 for Suppressing the Cardiovascular Response to Tracheal Intubation During Fixed Sufentanil–Esketamine Induction: An Age-Stratified Dixon Up-and-Down Study
AU - Xiaofen Lin
AU - Qing Wan
AU - Ruwen Huang
AU - Rui Li
AU - Mengrong Hu
PY - 2026
DA - 2026/11/01
JO - Drug Design, Development and Therapy
DO - 10.2147/dddt.s658705
UR - https://doi.org/10.2147/dddt.s658705
AB - Purpose: To estimate the ciprofol pump-predicted effect-site target concentration associated with a 50% probability of suppressing the cardiovascular response to tracheal intubation (Ce50) during fixed sufentanil-esketamine induction in two age cohorts. Patients and Methods: In this single-center, prospective, age-stratified Dixon up-and-down study, 53 adults undergoing elective surgery received sufentanil 0.3 μg/kg, esketamine 0.3 mg/kg, and ciprofol effect-site target-controlled infusion (TCI). Independent cohorts aged 45–64 and 65–79 years started at a pump-predicted target concentration (Ce) of 1.10 μg/mL, adjusted in 0.05 μg/mL steps. Ce50 was estimated by reversal-pair midpoints and Probit analysis. The trial was registered on March 31, 2026 (ChiCTR2600121464). Results: Thirty-two middle-aged and 21 older adults were analyzed. Midpoint Ce50 was 0.975 μg/mL (approximate 95% confidence interval [CI], 0.910–1.040) and 1.096 μg/mL (1.072–1.121), respectively. Probit Ce50 was 0.991 μg/mL (95% CI, 0.773–1.103) and 1.112 μg/mL (1.078–1.152). At target Ce, mean arterial pressure fell by 19.2% ± 11.0% and 22.5% ± 12.5% from baseline. Hypotension occurred in 20/32 (62.5%) and 13/21 (61.9%) participants. Conclusion: These exploratory Ce50 estimates are specific to the CONCERT-III pump model and the studied co-induction and rescue protocol in small, nonrandomized cohorts at a single center. Frequent hypotension and norepinephrine use accompanied induction. The estimates do not establish an independent age effect or individual dosing targets and require external validation. Trial Registration: Chinese Clinical Trial Registry, ChiCTR2600121464; prospectively registered March 31, 2026.
SN - 1177-8881
ER -