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不同剂量丙泊酚对老年糖尿病患者脊柱手术全身麻醉诱导血流动力学的影响:一项双盲、随机、对照研究

Effect of different doses of ciprofol on hemodynamics induced by general anesthesia in elderly diabetic patients undergoing spinal surgery: a double-blind, randomized, controlled study.

作者信息

Jiang Xiaorui, Zhang Linzhong, Ji Jiawei, Jing Yan, Li Meiping

机构信息

Department of Anaesthesia, Second Hospital of Shanxi Medical University, Taiyuan, 030001, China.

出版信息

BMC Anesthesiol. 2025 Jan 20;25(1):34. doi: 10.1186/s12871-024-02881-3.

DOI:10.1186/s12871-024-02881-3
PMID:39833684
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11744958/
Abstract

BACKGROUND

To evaluate the safety and efficacy of different doses of ciprofol for the induction of general anesthesia in elderly patients with diabetes undergoing spinal surgery.

METHODS

Ninety elderly diabetic patients scheduled for elective single-level posterior lumbar interbody fusion (PLIF) under general anesthesia were enrolled and randomly assigned to three groups according to the induction dose of ciprofol: group A (0.2 mg/kg), Group B (0.3 mg/kg), and Group C (0.4 mg/kg). The safety and efficacy of anesthesia induction were compared among the three groups.

CASE PRESENTATION

The incidence of hypotension in Group C (46.4%) was significantly higher than that in Groups A (7.4%) and B (14.8%) (P < 0.05). The area under the time-mean arterial pressure curve (AUT) was significantly greater in Group C (176.39 ± 33.83 mmHg·min) than in Group B (158.44 ± 26.55 mmHg·min) and Group A (143.59 ± 19.52 mmHg·min) (P < 0.05). The incidence of intubation response was highest in Group A (77.8%, P < 0.05). Significant differences in bispectral index (BIS) values were observed at 3, 4, and 5 min post-administration among the groups CONCLUSIONS: The induction regimen of 0.3 mg/kg ciprofol combined with 0.4 µg/kg sufentanil and 0.7 mg/kg rocuronium provided superior hemodynamic stability and reduced the need for vasoactive drugs in elderly diabetic patients. This regimen was found to be more favorable compared to the 0.2 mg/kg and 0.4 mg/kg ciprofol dosing groups, demonstrating an optimal balance of safety and efficacy during anesthesia induction in this high-risk population. This trial was registered in the Chinese Clinical Trial Registry on February 26, 2024 (Registration Number: ChiCTR2400081164).

摘要

背景

评估不同剂量丙泊酚用于老年糖尿病患者脊柱手术全身麻醉诱导的安全性和有效性。

方法

纳入90例计划在全身麻醉下行择期单节段后路腰椎椎间融合术(PLIF)的老年糖尿病患者,根据丙泊酚诱导剂量随机分为三组:A组(0.2mg/kg)、B组(0.3mg/kg)和C组(0.4mg/kg)。比较三组麻醉诱导的安全性和有效性。

病例呈现

C组低血压发生率(46.4%)显著高于A组(7.4%)和B组(14.8%)(P<0.05)。C组平均动脉压-时间曲线下面积(AUT)(176.39±33.83mmHg·min)显著大于B组(158.44±26.55mmHg·min)和A组(143.59±19.52mmHg·min)(P<0.05)。A组插管反应发生率最高(77.8%,P<0.05)。给药后3、4和5分钟时,各组间脑电双频指数(BIS)值存在显著差异。

结论

0.3mg/kg丙泊酚联合0.4μg/kg舒芬太尼和0.7mg/kg罗库溴铵的诱导方案在老年糖尿病患者中提供了更好的血流动力学稳定性,并减少了血管活性药物的使用。与0.2mg/kg和0.4mg/kg丙泊酚给药组相比,该方案更具优势,在这一高危人群麻醉诱导期间显示出安全性和有效性的最佳平衡。本试验于2024年2月26日在中国临床试验注册中心注册(注册号:ChiCTR2400081164)。

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本文引用的文献

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Pharmacol Res Perspect. 2023 Apr;11(2):e01066. doi: 10.1002/prp2.1066.
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Safety, Pharmacokinetics, and Pharmacodynamics of a Single Bolus of the γ-aminobutyric Acid (GABA) Receptor Potentiator HSK3486 in Healthy Chinese Elderly and Non-elderly.
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Perioperative Blood Pressure Management.围手术期血压管理
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