在接受腺样体切除术和腺扁桃体切除术的儿童中使用环丙酚：回顾性队列研究

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2024-09-06 DOI:10.2147/dddt.s478994

Chao Zeng, Lu Li, Mengrui Wang, Jun Xiong, Wenjuan Pang, Haiyan Yu, Jiadi He, Xuguang Wang, Yingying Chen, Yanyan Sun

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引用次数: 0

摘要

目的：环丙酚是一种新型麻醉剂，其疗效和安全性已得到验证，临床应用范围也在不断扩大。然而，有关儿童使用环丙酚的知识却很少。本研究旨在评估与异丙酚相比，异丙酚在儿童腺样体切除术和腺扁桃体切除术全身麻醉中的安全性和有效性：我们回顾性分析了 2023 年 6 月至 8 月期间接受腺样体切除术或腺扁桃体切除术全身麻醉的儿童数据，以评估环丙酚的安全性和有效性。主要结果包括诱导过程中的血流动力学变化和麻醉后护理病房的术后并发症。次要结果包括拔管时间、小儿麻醉后谵妄（PAED）评分。同时，根据年龄进行了亚组分析：301名儿童符合纳入标准，其中157名接受了异丙酚诱导，144名接受了丙泊酚诱导。两组患者的人口统计学和手术相关信息相似。但丙泊酚组的右美托咪定用量明显高于异丙酚组（P=0.001）。两组在诱导和插管期间的血流动力学变化趋势相同。插管后 10min 和 20min 的 PAED 评分在环丙酚组明显降低（p< 0.001 和 p=0.046）。此外，在≤72个月和> 72个月亚组中，环丙酚组在拔管后10分钟的评分也明显降低。在人群和≤72个月的亚组中，当评分为> 10时，环丙酚组在拔管后10min和20min出现谵妄的发生率明显降低（P=0.03和P=0.02）。两组患者均未出现明显的术后并发症：结论：环丙酚在儿童麻醉诱导中表现出优势特点，如血流动力学稳定、术后谵妄发生率相对较低且无明显麻醉后并发症。环丙酚可能成为儿童患者全身麻醉的一种新选择。

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Ciprofol in Children Undergoing Adenoidectomy and Adenotonsillectomy: A Retrospective Cohort Study

Objective: Ciprofol is a novel anesthetic agent, its efficacy and safety had been verified and its clinical implementation has been expanded. However, the knowledge about ciprofol in children is meager. The aim of study is to evaluate the safety and effectiveness of ciprofol in general anesthesia in children undergoing adenoidectomy and adenotonsillectomy, compared with propofol.
Materials: We retrospectively analyzed data of children who underwent adenoidectomy or adenotonsillectomy with general anesthesia from June to August 2023 to evaluate the safety and effectiveness of ciprofol. The primary outcomes included hemodynamic changes during induction and postoperative complications in post-anesthesia care unit. The secondary outcomes were extubation time, pediatric anesthesia emergence delirium (PAED) score. Meanwhile, subgroup analysis was performed based on age.
Results: 301 children met the inclusion criteria, 157 received ciprofol induction and 144 received propofol. Patient demographics and operation-related information were similar in the two groups. However, the dosage of dexmedetomidine in the propofol group was significantly higher than that of the ciprofol group (p=0.001). The trends of hemodynamic shift during induction and intubation were the same in the two groups. The PAED scores on post-extubation 10min and 20min were significantly reduced in the ciprofol group (p< 0.001 and p=0.046). Moreover, in the ≤ 72 months and the > 72 months subgroups, the scores were also significantly lower in the ciprofol group on post-extubation 10min. With the score of > 10, the incidence of emergence delirium of the ciprofol group was significantly lower on post-extubation 10min and 20min in the population and the ≤ 72 months subgroups (p=0.03 and p=0.02). There were no obvious postoperative complications in both groups.
Conclusion: Ciprofol exhibited advantageous characteristics in the induction of children, such as stable hemodynamics, a relatively lower incidence of postoperative delirium without apparent post-anesthesia complications. Ciprofol may emerge as a novel option for general anesthesia in pediatric patients.

Keywords: ciprofol, propofol, adenoidectomy, child, general anesthesia, delirium

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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.