【罂粟摘要】环泊酚在接受腺样体切除术或腺样体扁桃体切除术儿童中的应用

环泊酚是一种新型麻醉剂，其疗效和安全性已得到证实，并广泛用于临床麻醉中。然而，环泊酚在儿科麻醉中的应用较少。本研究旨在评估环泊酚在接受腺样体切除术或腺样体扁桃体切除术儿童全身麻醉中的安全性和有效性。

本研究回顾性分析了2023年6月至8月在全身麻醉下接受腺样体切除术或腺样体扁桃体切除术患儿的数据，以评估环泊酚的安全性和有效性。主要结局包括诱导期间血流动力学的变化以及在麻醉后恢复室中发生的术后并发症。次要结局是拔管时间、儿科麻醉苏醒期谵妄（PAED）评分。同时，根据年龄进行亚组分析。

本研究共纳入301例儿童，157例接受环泊酚诱导，144例接受丙泊酚诱导。两组患者人口统计学和手术相关信息相似。丙泊酚组中右美托咪定的剂量显著高于环泊酚组（P = 0.001）。两组诱导和插管期间血流动力学变化趋势相同。环泊酚组在拔管后10 min和20 min时的PAED评分显著降低（P < 0.001和 P = 0.046）。此外，在年龄≤72个月和年龄>72个月的亚组中，环泊酚组拔管后10 min PAED评分也显著降低。在PAED评分>10分的人群中，环泊酚组在拔管后10 min和20 min苏醒期谵妄的发生率较丙泊酚组和年龄≤72个月的亚组显著降低（P = 0.03和 P = 0.02）。两组均无明显的术后并发症。

环泊酚在儿童诱导方面表现出一定的优势，例如稳定的血流动力学、相对较低的术后谵妄发生率，无明显麻醉后并发症。环泊酚可能成为儿科患者全身麻醉的一种新选择。

原始文献来源：Zeng C, Li L, Wang M, et al. Ciprofol in Children Undergoing Adenoidectomy and Adenotonsillectomy: A Retrospective Cohort Study. Drug Des Devel Ther. 2024;18:4017-4027. Published 2024 Sep 6.

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.