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接受腺样体切除术和扁桃体切除术的儿童中使用西普罗酚:一项回顾性队列研究。

Ciprofol in Children Undergoing Adenoidectomy and Adenotonsillectomy: A Retrospective Cohort Study.

机构信息

Department of Anesthesiology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, Guangdong, People's Republic of China.

Department of Anesthesiology, Peking University Third Hospital, Beijing, People's Republic of China.

出版信息

Drug Des Devel Ther. 2024 Sep 6;18:4017-4027. doi: 10.2147/DDDT.S478994. eCollection 2024.

Abstract

OBJECTIVE

Ciprofol is a novel anesthetic agent, its efficacy and safety had been verified and its clinical implementation has been expanded. However, the knowledge about ciprofol in children is meager. The aim of study is to evaluate the safety and effectiveness of ciprofol in general anesthesia in children undergoing adenoidectomy and adenotonsillectomy, compared with propofol.

MATERIALS

We retrospectively analyzed data of children who underwent adenoidectomy or adenotonsillectomy with general anesthesia from June to August 2023 to evaluate the safety and effectiveness of ciprofol. The primary outcomes included hemodynamic changes during induction and postoperative complications in post-anesthesia care unit. The secondary outcomes were extubation time, pediatric anesthesia emergence delirium (PAED) score. Meanwhile, subgroup analysis was performed based on age.

RESULTS

301 children met the inclusion criteria, 157 received ciprofol induction and 144 received propofol. Patient demographics and operation-related information were similar in the two groups. However, the dosage of dexmedetomidine in the propofol group was significantly higher than that of the ciprofol group (=0.001). The trends of hemodynamic shift during induction and intubation were the same in the two groups. The PAED scores on post-extubation 10min and 20min were significantly reduced in the ciprofol group (<0.001 and =0.046). Moreover, in the ≤72 months and the >72 months subgroups, the scores were also significantly lower in the ciprofol group on post-extubation 10min. With the score of >10, the incidence of emergence delirium of the ciprofol group was significantly lower on post-extubation 10min and 20min in the population and the ≤72 months subgroups (=0.03 and =0.02). There were no obvious postoperative complications in both groups.

CONCLUSION

Ciprofol exhibited advantageous characteristics in the induction of children, such as stable hemodynamics, a relatively lower incidence of postoperative delirium without apparent post-anesthesia complications. Ciprofol may emerge as a novel option for general anesthesia in pediatric patients.

摘要

目的

西普罗尔是一种新型麻醉剂,其疗效和安全性已得到验证,其临床应用也在不断扩大。然而,儿童对西普罗尔的了解甚少。本研究旨在评估西普罗尔在儿童腺样体切除术和扁桃体切除术全身麻醉中的安全性和有效性,并与丙泊酚进行比较。

材料

我们回顾性分析了 2023 年 6 月至 8 月期间接受全身麻醉腺样体切除术或扁桃体切除术的儿童数据,以评估西普罗尔的安全性和有效性。主要结局包括诱导期间的血流动力学变化和麻醉后监护室的术后并发症。次要结局为拔管时间、儿科麻醉苏醒期躁动(PAED)评分。同时,根据年龄进行了亚组分析。

结果

301 例患儿符合纳入标准,其中 157 例接受西普罗尔诱导,144 例接受丙泊酚诱导。两组患者的人口统计学和手术相关信息相似。然而,丙泊酚组的右美托咪定剂量明显高于西普罗尔组(=0.001)。两组诱导期间和插管期间的血流动力学变化趋势相同。拔管后 10min 和 20min,西普罗尔组的 PAED 评分明显降低(<0.001 和=0.046)。此外,在≤72 个月和>72 个月亚组中,拔管后 10min,西普罗尔组的评分也明显降低。在总人群和≤72 个月亚组中,以评分>10 为界,拔管后 10min 和 20min 时,西普罗尔组出现苏醒期躁动的发生率明显较低(=0.03 和=0.02)。两组均无明显术后并发症。

结论

西普罗尔在儿童诱导期表现出有利的特点,如血流动力学稳定,术后谵妄发生率相对较低,且无明显麻醉后并发症。西普罗尔可能成为儿科患者全身麻醉的一种新选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1d5/11385364/82cc135c8e93/DDDT-18-4017-g0001.jpg

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