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Published on: November 6, 2019
Ciprofol in Children Undergoing Adenoidectomy and Adenotonsillectomy: A Retrospective Cohort Study
Chao Zeng1, Lu Li1, Mengrui Wang2
1Department of Anesthesiology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, Guangdong, People's Republic of China.
Insights
Ciprofol offers a safer anesthetic option for children undergoing surgery, showing reduced emergence delirium compared to propofol. This novel agent provides stable hemodynamics and fewer complications in pediatric anesthesia.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Ciprofol is a new anesthetic with established efficacy and safety in adults.
- Limited data exists on ciprofol's use in pediatric populations.
- Adenoidectomy and adenotonsillectomy are common pediatric surgical procedures requiring general anesthesia.
Purpose of the Study:
- To evaluate the safety and effectiveness of ciprofol versus propofol for general anesthesia in children undergoing adenoidectomy and adenotonsillectomy.
- To compare hemodynamic changes, postoperative complications, extubation time, and emergence delirium between ciprofol and propofol.
Main Methods:
- Retrospective analysis of 301 children undergoing adenoidectomy or adenotonsillectomy.
- Comparison of ciprofol (n=157) versus propofol (n=144) anesthesia.
- Primary outcomes: hemodynamic changes and PACU complications. Secondary outcomes: extubation time and Pediatric Anesthesia Emergence Delirium (PAED) scores.
Main Results:
- Hemodynamic trends during induction and intubation were similar between groups.
- Ciprofol group showed significantly lower PAED scores at 10 and 20 minutes post-extubation (p<0.001, p=0.046).
- Lower incidence of emergence delirium in the ciprofol group, particularly in younger children (≤72 months). No significant postoperative complications were noted.
Conclusions:
- Ciprofol demonstrates stable hemodynamics and a reduced incidence of postoperative delirium in pediatric patients.
- Ciprofol presents a promising alternative anesthetic agent for pediatric general anesthesia.
- Further research may solidify ciprofol's role in pediatric surgical procedures.
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.
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