【原】【罂粟摘要】环泊酚对肺癌胸腔镜手术老年患者术后谵妄的影响：一项前瞻性、随机、对照试验

环泊酚对肺癌胸腔镜手术老年患者术后谵妄的影响：一项前瞻性、

随机、对照试验

贵州医科大学     麻醉与心脏电生理课题组

翻译：文春雷   编辑：田明德  审校：曹莹

目的：本研究旨在评估环泊酚与异丙酚对老年肺癌患者胸腔镜手术术后谵妄（POD）发生率的影响。

患者和方法：本研究共招募了84名接受肺癌胸腔镜手术的老年患者，并随机分为两组，分别接受环泊酚或异丙酚麻醉。主要结局是术后三天内POD的发生率。次要结局包括意识模糊评估法（CAM）评分、与平均动脉压（MAP）和颈动脉血流灌注指数（SctO₂）相关的围手术期指标。此外，还分析了与POD相关的MAP和SctO₂指标。

结果：环泊酚组和异丙酚组中POD的发生率分别为7.1%和16.7%（风险比[RR] 0.37；95%置信区间[CI]，0.07-2.03；风险差[RD]，-9.6%; 95% CI，-23.3% - 4.1%; p = 0.178）。与异丙酚组相比，环泊酚组患者在术后三天内具有较低的CAM评分(13 (12,15) vs 15 (14,17);12 (11,13) vs 14 (13,16);12 (11,12) vs 13(12,14),p<0 .05 ) 。此外，与异丙酚组相比，环泊酚组患者显示出更高的平均和最小MAP值(88.63±6.7 vs 85±8.3;69.81±9.59 vs 64.9±9.43,p<0.05 ) 和SctO₂水平(77.26±3.96 vs 75.3±4.49;71.69±4.51 vs 68.77±6.46,p<0.05)，以及血压稳定时间占总时间百分比(0.6±0.14 vs 0.45±0.14,p < 0.05 ) 。此外，MAP 和SctO₂相关指标被验证可能是POD的监测指标。

结论：使用环泊酚进行全身麻醉不会增加POD的发生率，结果表明环泊酚能改善术中MAP和SctO₂水平，减少术后CAM分数。

原始文献来源

Zhaohui Liu, Yi Jin, Lingfei Wang,et al.The Effect of Ciprofol on Postoperative Delirium in Elderly Patients Undergoing Thoracoscopic Surgery for Lung Cancer: A Prospective, Randomized, Controlled Trial.[J].Drug Design, Development and Therapy,2024,18:325–339.

The Effect of Ciprofol on Postoperative Delirium in Elderly Patients Undergoing Thoracoscopic Surgery for Lung Cancer: A Prospective, Randomized, Controlled Trial

Purpose:This study was conducted to assess whether ciprofol vs propofol could affect the incidence of postoperative delirium (POD) in elderly patients with lung cancer after thoracoscopic surgery.

Patients and Methods: In this study, a total of 84 elderly patients undergoing thoracoscopic surgery for lung cancer were recruited and randomized into two groups to receive anesthesia with either ciprofol or propofol. The primary outcome was the incidence of POD within three days after surgery. Secondary outcomes included the Confusion Assessment Method (CAM) score, intraoperative indicators related to mean arterial pressure (MAP), and cerebral tissue oxygen saturation (SctO2). Moreover, MAP- and SctO2- related indicators associated with POD were analyzed.

Results:The incidence of POD was 7.1% and 16.7%, respectively, in the ciprofol group and the propofol group (risk ratio [RR], 0.37; 95% confidence interval [CI], 0.07 to 2.03; risk difference [RD], −9.6%; 95% CI, −23.3% to 4.1%; p = 0.178). Compared with those in the propofol group, patients in the ciprofol group had lower CAM scores three days after surgery (13 (12, 15) vs 15 (14, 17); 12 (11, 13) vs 14 (13, 16); 12 (11, 12) vs 13 (12, 14), p<0.05). Besides, patients in the ciprofol group exhibited higher mean and minimum MAP (88.63 ± 6.7 vs 85 ± 8.3; 69.81 ± 9.59 vs 64.9 ± 9.43, p<0.05) and SctO2 (77.26 ± 3.96 vs 75.3 ± 4.49, 71.69 ± 4.51 vs 68.77 ± 6.46, p<0.05) and percentage of time for blood pressure stabilization (0.6 ± 0.14 vs 0.45 ± 0.14, p<0.05) than those in the propofol 

group. Furthermore, MAP and SctO2-related indicators were validated to correlate with POD.

Conclusion: Anesthesia with ciprofol did not increase the incidence of POD compared with propofol. The results demonstrated that ciprofol could improve intraoperative MAP and SctO2 levels and diminish postoperative CAM scores.

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