Saeed Abdallah, Elewidi Mariam, Nawlo Ahmad, Elzahaby Amr, Khaled Asmaa, Othman Abdalla, Abuelazm Mohamed, Abdelazeem Basel
Faculty of Medicine, Tanta University, Tanta, Gharbia, Egypt.
Department of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, West Virginia, USA.
Indian J Anaesth. 2024 Sep;68(9):776-794. doi: 10.4103/ija.ija_104_24. Epub 2024 Aug 16.
Propofol has been used in medical practice as an anaesthetic drug for producing and sustaining general anaesthesia due to its advantages. However, it also has drawbacks, including injection-related discomfort. Recently, ciprofol has emerged as a promising anaesthetic drug that may overcome many drawbacks associated with propofol. In this systematic review and meta-analysis, we assess the efficacy and safety of ciprofol compared to propofol in different anaesthesia procedures.
The study protocol was registered in the International Prospective Register of Systematic Reviews (ID: CRD42023458170). Central, PubMed, EMBASE, Scopus and WOS were searched for English literature until 26 February 2024. Meta-analysis was performed using RevMan. The risk of bias was assessed using the RoB 2.0 tool. Results were reported as risk ratios (RRs), mean differences (MDs) and 95% confidence intervals (CIs).
Nineteen randomised controlled trials were included in our analysis, with 2841 participants. There was no difference between ciprofol and propofol in the success rate of endoscopy (RR: 1.01, 95% CI: 0.99, 1.02; = 0.44), while ciprofol showed a significant increase in the success rate of general anaesthesia/sedation (RR: 1.01, 95% CI: 1.00, 1.02; = 0.04). Ciprofol showed significantly lower pain on injection (RR: 0.14, 95% CI: 0.09, 0.22; < 0.001), lower adverse events (RR: 0.80, 95% CI: 0.69, 0.92; = 0.002) and higher patient satisfaction (standardised mean difference (SMD): 0.36, 95% CI: 0.24, 0.48; < 0.001).
Ciprofol exhibited a comparable efficacy to propofol in inducing general anaesthesia and sedation with fewer adverse events, less pain on injection and higher patient satisfaction. These collective findings may suggest that ciprofol can be used as an alternative drug to ensure effective general anaesthesia/sedation induction in the future.
丙泊酚因其优势已在医学实践中用作产生和维持全身麻醉的麻醉药物。然而，它也有缺点，包括注射相关的不适。最近，环泊酚作为一种有前景的麻醉药物出现，可能克服与丙泊酚相关的许多缺点。在这项系统评价和荟萃分析中，我们评估了环泊酚与丙泊酚在不同麻醉程序中的疗效和安全性。
研究方案已在国际前瞻性系统评价注册库（注册号：CRD42023458170）中注册。检索了CENTRAL、PubMed、EMBASE、Scopus和WOS等数据库以获取截至2024年2月26日的英文文献。使用RevMan进行荟萃分析。使用RoB 2.0工具评估偏倚风险。结果以风险比（RRs）、平均差（MDs）和95%置信区间（CIs）报告。
我们的分析纳入了19项随机对照试验，共2841名参与者。环泊酚和丙泊酚在内镜检查成功率方面无差异（RR：1.01，95%CI：0.99，1.02；P = 0.44），而环泊酚在全身麻醉/镇静成功率方面有显著提高（RR：1.01，95%CI：1.00，1.02；P = 0.04）。环泊酚注射时疼痛显著更低（RR：0.14，95%CI：0.09，0.22；P < 0.001），不良事件更少（RR：0.80，95%CI：0.69，0.92；P = 0.002），患者满意度更高（标准化平均差（SMD）：0.36，95%CI：0.24，0.48；P < 0.001）。
环泊酚在诱导全身麻醉和镇静方面与丙泊酚疗效相当，不良事件更少，注射时疼痛更少，患者满意度更高。这些综合结果可能表明环泊酚未来可作为一种替代药物以确保有效的全身麻醉/镇静诱导。
