{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T22:57:37Z","timestamp":1783033057960,"version":"3.54.6"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T00:00:00Z","timestamp":1752883200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T00:00:00Z","timestamp":1752883200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Alfentanil, a short-acting \u00b5 opioid receptor agonist, has recently been confirmed that when combined with propofol for daytime hysteroscopy, it provided more stable hemodynamics compared with sufentanil, and has a lower incidence of hypoxemia and postoperative nausea and vomiting. The object of the trial was to determine the median effective dose (ED<jats:sub>50<\/jats:sub>) and the 95% effective dose (ED<jats:sub>95<\/jats:sub>) of alfentanil in inhibiting responses to cervical dilation when combined with ciprofol and explore the effect of alfentanil on reducing ciprofol requirement during hysteroscopy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>One hundred and forty patients scheduled hysteroscopy under monitored anesthesia care were randomized to receive a bolus of 8\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup>, 10\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup>, 12\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup>, 14\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> intravenous alfentanil or 0.15\u00a0\u00b5g\u22c5kg<jats:sup>\u22121<\/jats:sup> intravenous sufentanil followed by a bolus of 0.5\u00a0mg\u00b7kg<jats:sup>\u22121<\/jats:sup> ciprofol. Whether there was loss of response to cervical dilation or not in each patient was recorded. We used the probit analysis to determine ED<jats:sub>50<\/jats:sub> and ED<jats:sub>95<\/jats:sub> of alfentanil in inhibiting responses to cervical dilation when combined with ciprofol. The requirement of ciprofol, the emergence time, the visual analogue scale score of pain at five time points, and the incidence of adverse events were recorded.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The calculated ED<jats:sub>50<\/jats:sub> and ED<jats:sub>95<\/jats:sub> of alfentanil were 9.73 [95% CI 8.57 to 10.56] \u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> and 15.02 [95% CI 13.57 to 18.12] \u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup>, respectively. Ciprofol requirements were lower in patients given 10\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> (0.795 [ 0.707 to 0.889] mg\u00b7kg<jats:sup>\u22121<\/jats:sup>), 12\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> (0.799 [0.601 to 0.913] mg\u00b7kg<jats:sup>\u22121<\/jats:sup>), and 14\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> (0.789 [0.660 to 0.968] mg\u00b7kg<jats:sup>\u22121<\/jats:sup>) alfentanil than those given 8\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> alfentanil (1.082 [ 0.853 to 1.271] mg\u00b7kg<jats:sup>\u22121<\/jats:sup>) alfentanil and 0.15\u00a0\u00b5g\u22c5kg<jats:sup>\u22121<\/jats:sup> sufentanil (1.046 [0.861 to 1.427] mg\u00b7kg<jats:sup>\u22121<\/jats:sup>) (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Emergence time was lower in patients given 10\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> (0.9 [0.8 to 1.2] min), 12\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> (0.8 [0.6 to 1.0] min) than those given 8\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> (1.9 [1.0 to 2.8] min) and 14\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> (1.5 [1.0 to 2.3] min) alfentanil, and 0.15\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> sufentanil (1.4 [1.0 to 2.0] min) (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The visual analogue scale score of pain at the time of 30\u00a0min and 1\u00a0h after surgery was lower in patients given 10\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup>, 12\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup>, and 14\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> alfentanil when compared with 8\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> alfentanil and 0.15\u00a0\u00b5g\u22c5kg<jats:sup>\u22121<\/jats:sup> sufentanil (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The incidence of intraoperative hypotension was lower in patients given 8\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup>, 10\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup>, 12\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> alfentanil, and 14\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> alfentanil than those given 0.15\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> sufentanil (<jats:italic>P\u2009=<\/jats:italic>\u20090.044), while the incidence of intraoperative desaturation was higher in patients given 14\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> alfentanil than those given 8\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup>, 10\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup>, and 12\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> alfentanil, and 0.15\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> sufentanil (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>For women undergoing hysteroscopic surgery, a dose of 10\u201312\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> of alfentanil was associated with significant ciprofol-sparing effect, earlier anesthesia emergence, better postoperative analgesia, and less unexpected hemodynamic events compared with sufentanil, but 14\u00a0\u00b5g\u00b7kg<jats:sup>\u22121<\/jats:sup> alfentanil had the risk of transient desaturation and delayed anesthesia recovery. Indications and the optimal dose of alfentanil in this patient population need further clarification.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>The study was then registered on January 24, 2024 at the Chinese Clinical Trial Registry which participates in the World Health Organization International Clinical Trials Registry Platform (Identifier: ChiCTR2400080232) before enrolling the first participant and written informed consent was obtained by each patient.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12871-025-03217-5","type":"journal-article","created":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T10:56:33Z","timestamp":1752922593000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The median Effective Dose (ED50) and the 95% Effective Dose (ED95) of alfentanil in inhibiting responses to cervical dilation when combined with ciprofol during hysteroscopic procedure: a prospective, double-blind, dose-finding clinical study"],"prefix":"10.1186","volume":"25","author":[{"given":"Run","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Xi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Hong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Peng","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Jun","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin-Zhong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Li","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,19]]},"reference":[{"issue":"259","key":"3217_CR1","doi-asserted-by":"publisher","first-page":"208","DOI":"10.31729\/jnma.8063","volume":"61","author":"A Ghimire","year":"2023","unstructured":"Ghimire A, Ghimire S, Shrestha A, Pant SR, Subedi N, Pant PR. 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Pain Res Manag. 2016;2016:7868152.","journal-title":"Pain Res Manag"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03217-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-025-03217-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03217-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T14:42:50Z","timestamp":1757256170000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03217-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,19]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3217"],"URL":"https:\/\/doi.org\/10.1186\/s12871-025-03217-5","relation":{},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,19]]},"assertion":[{"value":"30 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Our research was approved by the Research Ethics Committee of Women\u2019s Hospital, Zhejiang University School of Medicine (IRB-20230325-R) on September 28, 2023. The protocol was registered at the Chinese Clinical Trial Registry (; Identifier: ChiCTR2400080232). The study was then conducted at the Women\u2019s Hospital Affiliated to Zhejiang University College of Medicine in Hangzhou, Zhejiang Province, China, from January 25th, 2024, to March 31th, 2024, with written informed consent from all included patients. My study adhered to the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"353"}}