Effects of Ciprofol- versus Remimazolam-Based Total Intravenous Anesthesia on Postoperative Nausea and Vomiting After Laparoscopic Cholecystectomy: A Randomized Controlled Trial.

IF 6.1 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2026-09-28 eCollection Date: 2026-01-01 DOI:10.2147/DDDT.S624552

Jinfang Zeng, Ying Ye, Zijian Li, Shu Yang, Jinjin Jian, Dongxiao Huang

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引用次数: 0

Abstract

Background: Postoperative nausea and vomiting (PONV) remains common after laparoscopic cholecystectomy. Whether ciprofol-based anesthesia reduces PONV compared with remimazolam-based anesthesia remains unclear.

Methods: In this single-center, randomized, assessor-blinded, parallel-group trial, adults undergoing laparoscopic cholecystectomy were assigned to receive ciprofol- or remimazolam-based total intravenous anesthesia. All participants received standardized antiemetic prophylaxis with dexamethasone and ondansetron, together with a standardized analgesic protocol. The primary outcome was the cumulative incidence of PONV within 24 h after surgery. Secondary outcomes included nausea, vomiting, rescue antiemetic use, postoperative pain, QoR-15 score, adverse events, and intraoperative hemodynamic variables.

Results: A total of 146 patients were randomized, with 73 patients in each group. The incidence of PONV within 24 h was lower in the ciprofol group than in the remimazolam group [23/73 (31.5%) vs 43/73 (58.9%); RR 0.53, 95% CI 0.36-0.79; P = 0.001]. This association remained significant after adjustment for clinically relevant PONV risk factors(adjusted OR 0.289, 95% CI 0.135-0.623; P = 0.002). Ciprofol was also associated with lower incidences of nausea, vomiting, and rescue antiemetic use. Postoperative pain, QoR-15 score, overall adverse events, and vasopressor use were similar between groups.

Conclusion: Under a standardized prophylactic antiemetic protocol, ciprofol-based total intravenous anesthesia was associated with a lower 24-h incidence of PONV than remimazolam-based anesthesia in adults undergoing laparoscopic cholecystectomy. No statistically significant between-group differences were observed in postoperative recovery measures, adverse events, or vasopressor use; however, the trial was not powered to establish equivalence for these secondary or safety outcomes. Further multicenter studies are needed to confirm the robustness and generalizability of this finding across different multimodal antiemetic strategies.

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环丙酚与雷马唑仑全静脉麻醉对腹腔镜胆囊切除术后恶心呕吐的影响：一项随机对照试验。

背景：腹腔镜胆囊切除术后恶心和呕吐（PONV）仍然很常见。与瑞马唑仑麻醉相比，以环丙酚为基础的麻醉是否能减少PONV仍不清楚。方法：在这项单中心、随机、评估盲、平行组试验中，接受腹腔镜胆囊切除术的成年人被分配接受环丙酚或雷马唑仑全静脉麻醉。所有参与者都接受了标准化的止吐预防，包括地塞米松和昂丹司琼，以及标准化的镇痛方案。主要终点是术后24小时内PONV的累积发生率。次要结局包括恶心、呕吐、抢救止吐药使用、术后疼痛、QoR-15评分、不良事件和术中血流动力学变量。结果：随机抽取146例患者，每组73例。环丙酚组24 h内PONV发生率低于雷马唑仑组[23/73 (31.5%)vs 43/73 (58.9%)；Rr 0.53, 95% ci 0.36-0.79；P = 0.001]。在对临床相关PONV危险因素进行校正后，这种相关性仍然显著（校正OR 0.289, 95% CI 0.135-0.623; P = 0.002）。环丙酚还与恶心、呕吐和抢救止吐药的发生率较低有关。术后疼痛、QoR-15评分、总体不良事件和血管加压药物的使用在两组之间相似。结论：在标准化预防性止吐方案下，环丙酚全静脉麻醉与雷马唑仑麻醉相比，成人腹腔镜胆囊切除术患者24小时PONV发生率较低。在术后恢复措施、不良事件或血管加压药物的使用方面，组间无统计学差异；然而，该试验并没有建立这些次要或安全性结果的等效性。需要进一步的多中心研究来证实这一发现在不同多模式止吐策略中的稳健性和普遍性。

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

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.