环泊酚用于手术室外镇静和麻醉的有效性和安全性的Meta分析  

Efficacy and safety of ciprofol for procedural sedation and anesthesia outside the operating room:a meta-analysis

作　　者：许云鹏 冷玉芳[4] 郑家怡 李红瑞 牛文杰 薛兴[5] 马晓丽[6] 刘健 XU Yunpeng;LENG Yufang;ZHENG Jiayi;LI Hongrui;NIU Wenjie;XUE Xing;MA Xiaoli;LIU Jian(First Clinical Medical College,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,730000 [2]甘肃省妇幼保健院(甘肃省中心医院)麻醉科 [3]兰州大学第二临床医学院 [4]兰州大学第一医院麻醉科 [5]兰州大学第一医院日间手术中心 [6]兰州大学第一医院胸外科

出　　处：《临床麻醉学杂志》2024年第7期727-734,共8页Journal of Clinical Anesthesiology

基　　金：甘肃省自然科学基金(21JR1RA092)。

摘　　要：目的系统评价环泊酚在手术室外镇静和麻醉中的有效性和安全性。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方、中国生物医学文献数据库(CBM)和维普等数据库,纳入关于环泊酚用于手术室外镇静和麻醉的有效性与安全性的随机对照试验(RCT),检索时间为建库至2023年6月,采用RevMan 5.4软件及Stata 15.0进行统计分析。结果共纳入12篇RCTs,患者2192例,其中环泊酚组1154例,丙泊酚组1038例。与丙泊酚组比较,环泊酚组麻醉诱导成功时间(MD=0.28 min,95%CI 0.08~0.47 min,P=0.006)和麻醉苏醒时间(MD=1.16 min,95%CI 0.44~1.87 min,P=0.001)明显延长,注射痛(OR=0.04,95%CI 0.02~0.06,P<0.001)、低血压(OR=0.64,95%CI 0.49~0.83,P=0.0008)、低氧血症(OR=0.44,95%CI 0.21~0.91,P=0.03)、呼吸抑制(OR=0.19,95%CI 0.11~0.32,P<0.001)发生率明显降低。两组镇静成功率、医师满意度、体动、心动过缓、恶心呕吐、头晕发生率差异无统计学意义。结论环泊酚与丙泊酚用于手术室外麻醉的效果相当,但环泊酚对患者呼吸功能影响更小,血流动力学更稳定,且注射痛、低血压、低氧血症、呼吸抑制等不良反应发生率明显低于丙泊酚。Objective To systematically evaluate the efficacy and safety of ciprofol for sedation and anesthesia outside the operating room.Methods Databases such as PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang Data,CBM,and VIP were searched for randomized controlled trials(RCTs)related to the efficacy and safety of ciprofol for sedation and anesthesia outside the operating room.The search covered all publications up to June 2023.Statistical analysis was performed using RevMan 5.4 software and Stata 15.0.Results Twelve RCTs were included,involving 2192 patients,of which 1154 were in the ciprofol group and 1038 in the propofol group.Compared with the propofol group,the anesthesia induction time(MD=0.28 min,95%CI 0.08-0.47 min,P=0.006)and recovery time(MD=1.16 min,95%CI 0.44-1.87 min,P=0.001)were significantly longer in the ciprofol group,and the incidences of injection pain(OR=0.04,95%CI 0.02-0.06,P<0.001),hypotension(OR=0.64,95%CI 0.49-0.83,P=0.0008),hypoxemia(OR=0.44,95%CI 0.21-0.91,P=0.03),and respiratory depression(OR=0.19,95%CI 0.11-0.32,P<0.001)were significantly lower.There were no statistically significant differences between the two groups in terms of sedation success rate,physician satisfaction,the difference in heart rate before and after anesthesia induction,incidence of body movement,bradycardia,nausea and vomiting,and dizziness.Conclusion The anesthetic effect of cyclopofol and propofol is similar when used for anesthesia outside the operating room.Compared to propofol,ciprofol offers comparable anesthetic effects for sedation and anesthesia outside the operating room,with a lesser impact on respiratory function and more stable hemodynamics.Ciprofol also significantly lowers the incidence of adverse reactions such as injection pain,hypotension,hypoxemia,and respiratory depression.

关 键 词：催眠药 镇静药 全身麻醉 META分析 

分 类 号：R614[医药卫生—麻醉学]