A meta-analysis and systematic review based on perioperative management of elderly patients: is ciprofol an alternative to propofol?

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2025-01-01 Epub Date: 2024-11-20 DOI:10.1007/s00228-024-03782-7

Wei Chen, YuGuang Xu, YaFei Zeng, GuiPing Xing

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引用次数: 0

Abstract

Purpose: With the rising number of elderly surgical patients, selecting an appropriate anesthetic tailored to their specific needs is essential. Ciprofol, a novel intravenous anesthetic, has garnered attention due to its low injection pain rate and minimal impact on the circulatory system. This meta-analysis aims to examine the efficacy and safety profile of ciprofol during perioperative management of elderly patients.

Methods: Comprehensive searches of PubMed, Embase, Cochrane, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases from inception to March 23, 2024, were conducted. Eligible studies were included, data extracted, quality assessed using the ROB2 tool, and analyses performed with Stata 17.0.

Results: Analysis of eleven randomized controlled trials (RCTs) comprising 1715 patients demonstrated that ciprofol outperformed propofol regarding injection pain (RR: 0.13, 95% CI: 0.09-0.20, p < 0.001), hypotension (RR: 0.72; 95% CI: 0.56-0.94; p = 0.014), bradycardia (RR: 0.64, 95% CI: 0.48-0.85, p = 0.002), respiratory depression (RR: 0.29, 95% CI: 0.19-0.43, p < 0.001), hypoxemia (RR: 0.38, 95% CI: 0.26-0.55, p < 0.001), and body movement (RR: 0.73, 95% CI: 0.56-0.96, p = 0.022). No significant differences were observed in induction time(SMD: 0.11,95% CI: -0.39-0.61, p = 0.655), sedative success rate(RR:1.01,,:95% CI:0.97-1.06, p = 0.669)), time of leaving the operating room(SMD-0.21,95% CI: -0.83-0.40, p = 0.497), bucking(RR:0.56,:95% CI:0.27-1.17, p = 0.134)), nausea and vomiting(RR:0.69,95% CI:0.43-1.11, p = 0.143)).

Conclusion: Ciprofol demonstrates comparable efficacy to propofol in general anesthesia for elderly patients, with an enhanced safety profile, making it a viable clinical alternative. Further well-designed large RCTs are required to substantiate its safety profile.

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基于老年患者围手术期管理的荟萃分析和系统综述：异丙酚是异丙酚的替代品吗？

目的：随着老年手术患者人数的不断增加，选择一种适合他们特殊需求的麻醉剂至关重要。环丙酚是一种新型静脉麻醉剂，因其注射疼痛低、对循环系统影响小而备受关注。本荟萃分析旨在研究环丙酚在老年患者围手术期治疗中的有效性和安全性：方法：对PubMed、Embase、Cochrane、Web of Science、中国国家知识基础设施（CNKI）、万方和VIP数据库从开始到2024年3月23日进行了全面检索。纳入符合条件的研究，提取数据，使用 ROB2 工具进行质量评估，并使用 Stata 17.0 进行分析：对包含 1715 名患者的 11 项随机对照试验（RCT）进行的分析表明，在注射疼痛方面，环丙酚的疗效优于异丙酚（RR：0.13，95% CI：0.09-0.20，P 结论：环丙酚的疗效与异丙酚相当：在对老年患者进行全身麻醉时，环丙酚的疗效与异丙酚相当，而且安全性更高，因此是一种可行的临床替代方案。为证实其安全性，需要进一步开展设计良好的大型 RCT 研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.