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1.广西中医药大学瑞康临床医学院,南宁 530200
2.绵阳市中医医院麻醉科, 四川 绵阳 621000
3.广西中医药大学附属瑞康医院麻醉科,南宁 530011
主治医师,硕士研究生。研究方向:围术期重要脏器功能保护、急慢性疼痛临床研究。E-mail:532597179@qq.com
主任医师,副教授,博士。研究方向:围术期重要脏器功能保护、急慢性疼痛、中西医结合临床基础、医药化工的基础和临床研究。E-mail:lfjyyq@163.com
收稿日期:2024-10-11,
修回日期:2025-02-24,
录用日期:2025-02-26,
纸质出版日期:2025-04-30
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冯嘉慧,邹和林,李福军.环泊酚复合局麻用于老年患者痔疮切除术的效果及安全性研究 Δ[J].中国药房,2025,36(08):970-974.
FENG Jiahui,ZOU Helin,LI Fujun.Study on the effect and safety of ciprofol combined with local anesthesia on elderly patients undergoing hemorrhoidectomy[J].ZHONGGUO YAOFANG,2025,36(08):970-974.
冯嘉慧,邹和林,李福军.环泊酚复合局麻用于老年患者痔疮切除术的效果及安全性研究 Δ[J].中国药房,2025,36(08):970-974. DOI: 10.6039/j.issn.1001-0408.2025.08.14.
FENG Jiahui,ZOU Helin,LI Fujun.Study on the effect and safety of ciprofol combined with local anesthesia on elderly patients undergoing hemorrhoidectomy[J].ZHONGGUO YAOFANG,2025,36(08):970-974. DOI: 10.6039/j.issn.1001-0408.2025.08.14.
目的
2
评估环泊酚复合局麻用于老年患者痔疮切除术的效果和安全性。
方法
2
纳入2023年2月-2024年6月广西中医药大学附属瑞康医院肛肠科行痔疮切除术的老年患者108例,按计算机生成的随机序列将其分为依托咪酯组(54例)和环泊酚组(54例);剔除术中出血、拒绝术后检查的患者各1例,最终有106例患者完成本试验(依托咪酯组52例、环泊酚组54例)。两组患者分别在依托咪酯0.2 mg/kg或环泊酚0.3 mg/kg+舒芬太尼0.1 μg/kg辅助镇静联合局麻下行痔疮切除术。观察两组患者的镇静有效率,麻醉诱导时长,苏醒时长,手术时长,入室(T
0
)时、麻醉诱导成功(T
1
)时、手术开始10 min(T
2
)时、苏醒(T
3
)时的血流动力学指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO
2
)、呼吸频率(RR)
]
,以及T
0
、T
2
、T
3
时的血清氧化应激指标[丙二醛(MDA)和超氧化物歧化酶(SOD)
]
水平,并记录不良反应发生情况。
结果
2
环泊酚组患者的麻醉诱导时长显著短于依托咪酯组(
P
<0.05),苏醒时长显著长于依托咪酯组(
P
<0.05);两组患者T
1
、T
2
时的HR、MAP、RR均较同组T
0
时显著降低(
P
<0.05),但组间各时间点
各血流动力学指标比较,差异均无统计学意义(
P
>0.05);两组患者T
2
、T
3
时MDA水平均显著高于同组T
0
时,SOD水平则显著低于同组T
0
时,且环泊酚组显著优于同期依托咪酯组(
P
<0.05);环泊酚组术中发生体动的患者比例显著低于依托咪酯组(
P
<0.05)。
结论
2
当环泊酚应用于老年患者痔疮切除术时,与依托咪酯相比,其在维持血流动力学稳定、抗氧化应激方面具有一定优势,且安全性较高。
OBJECTIVE
2
To evaluate the effect and safety of ciprofol combined with local anesthesia on elderly patients undergoing hemorrhoidectomy.
METHODS
2
A total of 108 elderly patients who underwent hemorrhoidectomy at the Department of Proctology, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from February 2023 to June 2024, were included. The patients were randomly divided into the etomidate group (54 cases) and the ciprofol group (54 cases) based on a computer-generated random sequence. One patient with intraoperative bleeding and one who refused postoperative examination were excluded, resulting in a final total of 106 patients completing this trial (52 in the etomidate group and 54 in the ciprofol group). The two groups of patients underwent hemorrhoidectomy under local anesthesia with sedative assistance, receiving either etomidate at 0.2 mg/kg or ciprofol at 0.3 mg/kg combined with sufentanil at 0.1 μg/kg. The sedation success rate, induction time, recovery time, operation time and hemodynamic parameters [heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO
2
) and respiratory rate (RR)
]
were observed at baseline (T
0
), after successful induction of anesthesia (T
1
), 10 minutes after the start of surgery (T
2
), and awakening (T
3
). Additionally, the levels of oxidative stress markers [malondialdehyde (MDA) and superoxide dismutase (SOD)
]
were measured at T
0
, T
2
and T
3
. The occurrence of adverse reactions was also recorded.
RESULTS
2
The induction time of the ciprofol group was significantly shorter than that of the etomidate group (
P
<0.05), while the recovery time was significantly longer in the ciprofol group compared to the etomidate group (
P
<0.05). At T
1
and T
2
, HR, MAP and RR of two groups were significantly lower compared to the same group at T
0
(
P
<0.05). However, no significant differences were observed in the hemodynamic parameters at each time point between the two groups (
P
>0.05). At T
2
and T
3
, the MDA levels in both groups were significantly higher than at T
0
, while the SOD levels were significantly lower than the same group at T
0
; the ciprofol group showed significantly better outcomes than the etomidate group at the same time points (
P
<0.05). The proportion of patients with intraoperative somatic movements was significantly lower in the ciprofol group compared to the etomidate group (
P
<0.05).
CONCLUSIONS
2
When ciprofol is used in elderly patients undergoing hemorrhoidectomy, it demonstrates certain advantages over etomidate in maintaining hemodynamic stability and reducing oxidative stress. Additionally, ciprofol has higher safety.
ROSENFELDT F , WILSON M , LEE G , et al . Oxidative stress in surgery in an aging population:pathophysiology and therapy [J ] . Exp Gerontol , 2013 , 48 ( 1 ): 45 - 54 .
WANG L L , KANG M , DUAN L X , et al . Effect of single spinal anesthesia with two doses ropivacaine on urinary retention after hemorrhoidectomy in male patients [J ] . Front Surg , 2023 , 9 : 1077575 .
SIKAKULYA F K , SSEBUUFU R , OKEDI X F , et al . Pain assessment following open hemorrhoidectomy under local anesthesia versus saddle block:a multicenter randomized controlled trial [J ] . BMC Surg , 2023 , 23 ( 1 ): 124 .
LOHSIRIWAT V , JITMUNGNGAN R . Strategies to reduce post-hemorrhoidectomy pain:a systematic review [J ] . Medicina(Kaunas) , 2022 , 58 ( 3 ): 418 .
JARRETT R T , BLAIR J L , SHOTWELL M S . Optimal BIS reference functions for closed-loop induction of anesthesia with propofol [J ] . Comput Biol Med , 2022 , 144 : 105289 .
WILLIAMS L M , BOYD K L , FITZGERALD B M . Etomidate [EB/OL ] . [ 2024-09-27 ] . https://europepmc.org/article/nbk/nbk535364 https://europepmc.org/article/nbk/nbk535364 .
GUO J , QIAN Y T , ZHANG X J , et al . Remimazolam tosilate compared with propofol for gastrointestinal endoscopy in elderly patients:a prospective,randomized and controlled study [J ] . BMC Anesthesiol , 2022 , 22 ( 1 ): 180 .
JING N , TIAN A Y . Etomidate vs propofol in older surgical patients [J ] . JAMA Surg , 2023 , 158 ( 4 ): 429 .
BIAN Y C , ZHANG H , MA S , et al . Mass balance,pharmacokinetics and pharmacodynamics of intravenous HSK3486,a novel anaesthetic,administered to healthy subjects [J ] . Br J Clin Pharmacol , 2021 , 87 ( 1 ): 93 - 105 .
TENG Y , OU M C , WANG X , et al . Pharmacokinetic and pharmacodynamic properties of ciprofol emulsion in Chinese subjects:a single center,open-label,single-arm dose-escalation phase 1 study [J ] . Am J Transl Res , 2021 , 13 ( 12 ): 13791 - 13802 .
倪春平 , 程善飞 , 丰浩荣 . 依托咪酯复合七氟烷用于全麻维持对机体应激反应的影响 [J ] . 广东医学 , 2020 , 41 ( 19 ): 2020 - 2023 .
MUHOZA B G , 梁增辉 , 谢艳乐 , 等 . 环泊酚诱导行腹部手术老年患者意识消失的半数有效量评估 [J ] . 郑州大学学报(医学版) , 2024 , 59 ( 4 ): 488 - 491 .
CHERNIK D A , GILLINGS D , LAINE H , et al . Validity and reliability of the observer’s assessment of alertness/ sedation scale:study with intravenous midazolam [J ] . J Clin Psychopharmacol , 1990 , 10 ( 4 ): 244 - 251 .
李玲瑶 , 李术榕 , 李响 , 等 . 环泊酚临床应用现状及研究进展 [J ] . 心肺血管病杂志 , 2023 , 42 ( 1 ): 97 - 99 .
邓怀冬 . 依托咪酯致全身性肌痉挛死亡1例 [J ] . 医药导报 , 2024 , 43 ( 7 ): 1144 - 1145 .
ZHU Q M , LUO Z , WANG X , et al . Efficacy and safety of ciprofol versus propofol for the induction of anesthesia in adult patients:a multicenter phase Ⅱa clinical trial [J ] . Int J Clin Pharm , 2023 , 45 ( 2 ): 473 - 482 .
ZHENG Z L , SU Y Q , FAN X Y , et al . BIS feedback closed-loop target-controlled infusion of propofol or etomidate in elderly patients with spinal surgery [J ] . Am J Transl Res , 2023 , 15 ( 2 ): 1231 - 1238 .
王太云 , 刘宜平 , 李恩有 . 依托咪酯常见不良反应及预防新策略研究进展 [J ] . 中国医药 , 2021 , 16 ( 9 ): 1411 - 1414 .
HUDAIB M , MALIK H , ZAKIR S J , et al . Efficacy and safety of ciprofol versus propofol for induction and maintenance of general anesthesia:a systematic review and meta-analysis [J ] . J Anesth Analg Crit Care , 2024 , 4 ( 1 ): 25 .
LAHER I . Systems biology of free radicals and antioxidants [M ] . Heidelberg : Springer Berlin Heidelberg , 2014 : 3929 - 3946 .
ROKSANDIC MILENKOVIC M , KLISIC A , CERIMAN V , et al . Oxidative stress and inflammation parameters-novel biomarkers for idiopathic pulmonary fibrosis [J ] . Eur Rev Med Pharmacol Sci , 2022 , 26 ( 3 ): 927 - 934 .
DJURIC M , KOSTIC S , NIKOLIC TURNIC T , et al . The comparison of the effects of ketamine and etomidate on cardiodynamics,biochemical and oxidative stress para-meters in Wistar male rats [J ] . Mol Cell Biochem , 2020 , 474 ( 1/2 ): 125 - 134 .
LEE E H , SHIN J W , YOON S K , et al . Effects of propofol and etomidate on hydrogen peroxide-induced oxidative damage in hepatocyte [J ] . Korean J Anesthesiol , 2009 , 57 ( 3 ): 331 - 336 .
高飞 , 崔博群 , 马骏 . 环泊酚和依托咪酯在非体外循环冠状动脉旁路移植术中的抗氧化应激作用比较 [J ] . 中国医药 , 2023 , 18 ( 8 ): 1136 - 1139 .
刘云 , 孙玉江 , 刘焕奇 , 等 . 全麻恢复期苏醒延迟发生的原因分析和处理 [J ] . 黑龙江畜牧兽医 , 2004 ( 1 ): 37 - 38 .
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