Wuxi School of Medicine, Jiangnan University, Wuxi, China.
Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
BMC Anesthesiol. 2024 Oct 8;24(1):359. doi: 10.1186/s12871-024-02721-4.
Ciprofol is a new intravenous anesthetic with a similar chemical structure to propofol. We aimed to compare the incidence of adverse actions like injection pain and time indexes of ciprofol versus propofol on anesthesia in patients undergoing endoscopy. We also compared anesthetists' satisfaction during the procedure.
Two independent researchers (Liu and Zeng) searched the Cochrane Library, Embase databases, and PubMed for controlled clinical trials. This meta-analysis of randomized controlled trials (RCTs) was performed with the Review Manager, Stata and the Cochrane Risk-of-Bias 2 tool to evaluate methodological quality. Relative risks with 95% confidence interval (CI) were calculated for outcomes.
Ten trials, including 1545 patients, were examined in the current meta-analysis. During anesthesia in patients undergoing endoscopy, the incidence of injection pain was significantly reduced in the research group. Compared with propofol, the pooled risk difference (RD) with the use of ciprofol for injection pain for all the procedures was - 0.34 (95% confidence interval [CI], -0.48 to 0.19), and RR for hypotension was 0.73(95% CI:0.58 to 0.92). GRADE showed this meta-analysis has moderate or low confidence. Trial sequential analysis for mortality indicated insufficient sample size for a definitive judgment for lower incidence of hypotension.
In painless endoscopy, compared with propofol, ciprofol exhibited non-inferiority anesthesia/sedation in patients, and had a good safety profile with a lower incidence of pain on injection and may reduce the chance of hypotension. Trial sequential analysis suggested the need for more cases, and GRADE highlighted moderate certainty, emphasizing the necessity for further targeted RCTs.
PROSPERO, CRD42023433627.
西普罗夫是一种新型的静脉麻醉药物，其化学结构与丙泊酚相似。我们旨在比较西普罗夫与丙泊酚用于内镜检查患者麻醉时的注射痛发生率和时间指标，并比较麻醉医生在手术过程中的满意度。
两位独立的研究者（刘和曾）检索了 Cochrane 图书馆、Embase 数据库和 PubMed 中的对照临床试验。采用 Review Manager、Stata 和 Cochrane 偏倚风险 2 工具对随机对照试验（RCT）进行荟萃分析，以评估方法学质量。使用 95%置信区间（CI）计算结果的相对风险。
当前荟萃分析共纳入了 10 项试验，包括 1545 例患者。在接受内镜检查的患者中，研究组的注射痛发生率明显降低。与丙泊酚相比，西普罗夫用于所有手术的注射痛的 pooled risk difference（RD）为-0.34（95%CI：-0.48 至 0.19），RR 为 0.73（95%CI：0.58 至 0.92）。GRADE 显示该荟萃分析的可信度为中等或低等。对死亡率的试验序贯分析表明，需要更多的病例来确定低血压发生率较低的情况。
在无痛内镜检查中，与丙泊酚相比，西普罗夫在患者中表现出非劣效性的麻醉/镇静效果，具有良好的安全性，注射痛发生率较低，可能降低低血压的发生机会。试验序贯分析表明需要更多的病例，GRADE 强调了中等确定性，强调了进一步进行有针对性的 RCT 的必要性。
PROSPERO，CRD42023433627。
