Brazilian Journal of Anesthesiology最新文献

Therapeutic misconceptions: the protective role of the perioperative team 治疗误解-围手术期团队的保护作用。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2026-01-01 DOI: 10.1016/j.bjane.2025.844720

Britta S. von Ungern-Sternberg , Aine Sommerfield

引用次数: 0

Mechanical needle guidance for ultrasound-guided parasagittal oblique in-plane paravertebral blocks: a cadaveric study 超声引导下矢状旁斜椎旁阻滞的机械针引导：一项尸体研究。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2026-01-01 DOI: 10.1016/j.bjane.2025.844716

Hesham Elsharkawy , Ece Yamak Altinpulluk , Tetsuya Shimada , Ilker Ince , Guangmei Mao , Nicolas Mario Mas D Alessandro , Loran Mounir Soliman , Nair Harsha , Marta Kelava , Richard Drake , Xuan Pu , Daniel I. Sessler , Alparslan Turan

Background

Paravertebral blocks provide analgesia for a range of thoracoabdominal surgeries. However, visualizing the needle tip during the procedure can be challenging, especially for clinicians with limited experience, because the target is deep. We therefore tested the primary hypothesis that needle guidance by the Infiniti Plus system improves ultrasound visualization of the needle tip during thoracic paravertebral blocks performed by novice residents.

Methods

Nineteen clinical anesthesia residents each performed 20 bilateral ultrasound-guided thoracic paravertebral blocks (T2–T11) on 17 unembalmed cadavers, with and without the use of a fixed-angle mechanical needle guide in a randomized crossover design. The primary outcome, percent perfect needle visibility, was compared between guided and unguided methods using a paired t-test. Secondary outcomes, including time to needle visualization, number of needle insertion attempts, and subjective ease-of-use ratings, were analyzed using paired t-tests and Wilcoxon signed-rank tests, respectively. Inter-rater reliability for overall perception ratings was assessed using the Intraclass Correlation Coefficient (ICC).

Results

There were no significant differences in needle-target visualization (62% ± 17% with guidance vs. 64% ± 18% without, p = 0.15), time to target (HR = 1.00 [95% CI 0.86–1.16], p = 0.99), procedural difficulty scores, or number of insertion attempts between guided and unguided blocks.

Conclusion

The Infiniti Plus mechanical needle guide did not demonstrate improved ultrasound needle tip visualization during thoracic paravertebral blocks performed by novice clinicians in cadavers.

背景：椎旁阻滞为一系列胸腹外科手术提供镇痛。然而，在手术过程中可视化针尖可能具有挑战性，特别是对于经验有限的临床医生来说，因为目标很深。因此，我们验证了最初的假设，即在新手住院医师进行胸椎旁阻滞时，Infiniti Plus系统的针头引导可以改善针尖的超声可视化。方法：采用随机交叉设计，19名临床麻醉住院医师分别在17具非防腐尸体上进行了20次双侧超声引导下的胸椎旁阻滞（T2-T11），使用和不使用固定角度机械导针。使用配对t检验比较引导和非引导方法的主要结果，完美针头可见度百分比。次要结果，包括针的可视化时间、针插入次数和主观易用性评分，分别使用配对t检验和Wilcoxon符号秩检验进行分析。使用类内相关系数（ICC）评估整体感知评分的评分者间信度。结果：两组患者在针靶可见性（有引导组62%±17% vs无引导组64%±18%，p = 0.15）、到达靶点时间（HR = 1.00 [95% CI 0.86-1.16], p = 0.99）、手术难度评分、有引导和无引导组插入次数均无显著差异。结论：在新手临床医生对尸体进行胸椎旁阻滞时，Infiniti Plus机械导针器并没有显示出更好的超声针尖可视化。

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引用次数: 0

Between oceans and deserts: fluid balance and outcomes after liver transplantation 在海洋和沙漠之间：肝移植后的体液平衡和结果。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2026-01-01 DOI: 10.1016/j.bjane.2026.844721

Sergio Henrique Loss , Edino Parolo , Felippe Leopoldo Dexheimer Neto

引用次数: 0

Perioperative tranexamic acid in burn surgery: systematic review and meta-analysis of randomized controlled trials 烧伤手术围手术期氨甲环酸：随机对照试验的系统评价和荟萃分析。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-12-24 DOI: 10.1016/j.bjane.2025.844719

Maria Eduarda Molinari, Ramon Huntermann, Julia C. Bernardi, Nicoly Fiorese Andrade, Gustavo Barbosa David, Nicolas Ramos, Caroline de Oliveira Fischer Bacca

Introduction

Burn injuries often require surgery, posing challenges due to significant intraoperative blood loss and transfusion risks. Tranexamic Acid (TXA), an antifibrinolytic agent, stabilizes clots and reduces fibrinolysis, with proven efficacy in various surgical settings. However, the benefits in burn patients are yet to be established.

Methods

We performed a systematic review and meta-analysis. PubMed, Embase, and Cochrane databases were searched for Randomized Clinical Trials (RCTs) comparing TXA versus control in burned patients. Risk Ratios (RR) and Mean Differences (MD) with 95% CIs were computed for binary and continuous outcomes, respectively. The primary endpoint of interest was blood loss. Statistical analyses were performed using RStudio software (version 4.2.2). The certainty of the evidence was evaluated using the GRADE approach.

Results

Four RCTs comprising 204 patients were included, with 102 (50%) assigned to the TXA group. The mean patient age across studies ranged from 32.15 to 39.70 years. TXA significantly reduced total blood loss (MD = -183.93 mL; 95% CI: -278.44 to -89.42; p < 0.01), need for packed red blood cell transfusions (RR = 0.42, 95% CI 0.26 to 0.66; p < 0.01), while also improving hematocrit (MD = 3.49%; 95% CI: 1.58 to 5.41; p < 0.01) and hemoglobin levels (MD = 0.87 g.dL^-1; 95% CI: 0.35 to 1.39; p < 0.01).

Conclusion

In patients with burns, TXA was associated with reduced blood loss and packed cell transfusions. However, certainty is limited by the small number and heterogeneity of available trials

Registration

PROSPERO ID: CRD420251000356. Registered on 07 March 2025.

引言：烧伤通常需要手术，由于术中大量失血和输血风险，这带来了挑战。氨甲环酸（TXA）是一种抗纤溶剂，稳定凝块并减少纤溶，在各种手术环境中已被证明有效。然而，对烧伤患者的益处尚未确定。方法：我们进行了系统回顾和荟萃分析。检索PubMed， Embase和Cochrane数据库，比较烧伤患者TXA与对照组的随机临床试验（rct）。分别计算二元结局和连续结局的风险比（RR）和95% ci的平均差异（MD）。主要研究终点为失血量。采用RStudio软件（4.2.2版）进行统计分析。使用GRADE方法评估证据的确定性。结果：纳入4项随机对照试验，包括204例患者，其中102例（50%）分配到TXA组。研究中患者的平均年龄从32.15岁到39.70岁不等。TXA显著降低了总失血量（MD = -183.93 mL; 95% CI: -278.44 ~ -89.42; p < 0.01），压缩红细胞输注需求（RR = 0.42,95% CI 0.26 ~ 0.66; p < 0.01），同时也改善了红细胞压积（MD = 3.49%;95% CI: 1.58 ~ 5.41; p < 0.01）和血红蛋白水平（MD = 0.87 g.dL-1; 95% CI: 0.35 ~ 1.39; p < 0.01）。结论：在烧伤患者中，TXA与减少失血量和填充细胞输注有关。然而，确定性受到可用试验数量少和异质性的限制。注册：PROSPERO ID: CRD420251000356。于2025年3月7日注册

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引用次数: 0

Response to the Letter to the Editor regarding “Lateral versus posterior quadratus lumborum block in children undergoing open orchiopexy: a double-blind randomized clinical trial” 关于“开放性睾丸切除术儿童腰方肌外侧与后侧阻滞：一项双盲随机临床试验”的致编辑信的回复。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-12-06 DOI: 10.1016/j.bjane.2025.844718

Ozgecan P. Zanbak Mutlu, Pinar Kendigelen, Ayse C. Tutuncu

引用次数: 0

Intranasal dexmedetomidine for procedural sedation in children: a systematic review and meta-analysis 鼻内右美托咪定用于儿童手术镇静：一项系统回顾和荟萃分析。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-12-05 DOI: 10.1016/j.bjane.2025.844717

Kelvin Oliveira Rocha , Ellen Renata Ferreira de Araújo Santos , Mariana Madureira Pombeiro , Márcia Nayara da Silva Leite Fidelis , Fabiana Maria Kakehasi , Daniela Caldas Teixeira

Background

Intranasal Dexmedetomidine (IN-DEX) is a promising agent for pediatric procedural sedation due to its non-invasive route and favorable safety profile. However, a comprehensive synthesis quantifying its clinical timeline and safety as monotherapy is lacking. This meta-analysis assesses the efficacy and adverse events of IN-DEX as a standalone sedative in children.

Methods

Following PRISMA 2020 guidelines and PROSPERO registration (CRD420250652456), this meta-analysis systematically searched PubMed, ScienceDirect, and SciELO for intranasal dexmedetomidine monotherapy in children under 18 years from January 1, 2003, to July 1, 2025. Key outcomes included sedation success, onset, and duration. Data were pooled using a random-effects model, with risk-of-bias assessed via RoB2. We performed sensitivity and subgroup analyses and evaluated evidence certainty using the GRADE approach.

Results

Twenty-eight RCTs were included. The overall pooled mean onset time was 18.9 minutes and duration was 60.3 minutes, though both had very low evidence certainty due to high heterogeneity (I² > 99%). The overall success rate was 79.58%. Notably, in a subgroup of low-to-moderate risk-of-bias studies, a dose of [2, 3) mcg.kg^-1 achieved an 84.04% success rate, supported by high-quality evidence (GRADE: High, I² = 0%). The pooled proportions for key adverse events were hypotension (8.24%), bradycardia (5.08%), and desaturation (2.76%).

Conclusion

IN-DEX is an effective monotherapy for pediatric procedural sedation. Doses of [2, 3) mcg.kg^-1 are associated with high success rates, supported by high-quality evidence. While IN-DEX demonstrates a favorable respiratory profile with low desaturation rates, its use requires vigilant hemodynamic monitoring due to the risks of hypotension and bradycardia.

背景：鼻内右美托咪定（IN-DEX）由于其无创途径和良好的安全性，是一种很有希望用于儿科手术镇静的药物。然而，缺乏对其临床时间和单药安全性的综合评价。本荟萃分析评估了in - dex作为儿童独立镇静剂的疗效和不良事件。方法：本荟萃分析遵循PRISMA 2020指南和PROSPERO注册（CRD420250652456），系统检索PubMed、ScienceDirect和SciELO中2003年1月1日至2025年7月1日期间18岁以下儿童右美托咪定鼻内单药治疗的研究。主要结局包括镇静成功、发作和持续时间。使用随机效应模型汇总数据，并通过RoB2评估偏倚风险。我们进行敏感性和亚组分析，并使用GRADE方法评估证据确定性。结果：纳入28项随机对照试验。总体合并平均发病时间为18.9分钟，持续时间为60.3分钟，但由于异质性高（I²> 99%），两者的证据确定性都很低。总成功率为79.58%。值得注意的是，在低至中等偏倚风险研究的亚组中，[2,3]mcg的剂量。kg-1的成功率为84.04%，有高质量的证据支持（GRADE：高，I² = 0%）。主要不良事件的合并比例为低血压（8.24%）、心动过缓（5.08%）和去饱和（2.76%）。结论：IN-DEX是一种有效的儿科手术镇静单药。剂量为[2,3]mcg。高质量证据支持Kg-1与高成功率相关。虽然IN-DEX显示出良好的呼吸特征和低去饱和率，但由于低血压和心动过缓的风险，使用它需要警惕的血流动力学监测。

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引用次数: 0

Preoperative and postoperative anemia in major elective surgery: insights from a retrospective cohort in a Brazilian University Hospital 重大择期手术术前和术后贫血：来自巴西大学医院回顾性队列的见解。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-11-22 DOI: 10.1016/j.bjane.2025.844715

Lorena dos Santos Goiabeira , Sara Silva Meireles , Allan Santos Silva Leocádio , Heitor J.S. Medeiros , Fernanda Cunha Soares , Aline Macedo Pinheiro , Wallace Andrino da Silva

Background

Anemia is a common and critical condition in the perioperative management of patients undergoing major elective surgeries, posing significant risks to postoperative recovery. This study aimed to evaluate the prevalence of preoperative and postoperative anemia in surgical patients from a university hospital in northeastern Brazil.

Methods

This retrospective study included 508 patients aged 18 years or older who underwent major elective surgeries between October 2021 and October 2022. Anemia was defined according to World Health Organization criteria (hemoglobin < 13 g.dL^-1 for men and < 12 g.dL^-1 for women). Data were extracted from medical records and included preoperative and postoperative hemoglobin levels, surgical types, and transfusion requirements.

Results

Preoperative anemia was observed in 59.6% of 508 patients analyzed, with a mean Hb level of 11.66 (±/ 2.75) g.dL^-1 and 11.13 (± 2.08) g.dL^-1 for women and men, respectively. In the postoperative period, the anemia rate increased to 94.6%, with a mean Hb level of 9.36 (± 1.55) g.dL^-1 and 9.49 (± 1.36) g.dL^-1 for women and men, respectively. The transfusion rate was 27% in the total sample. Patients with preoperative anemia were 4.6 times more likely to require intraoperative transfusion compared to non-anemic patients (OR = 4.58; 95% CI: 2.78–7.52; p < 0.001). Higher preoperative hemoglobin levels were identified as protective against transfusion (OR = 0.65; 95% CI: 0.59–0.72; p < 0.001).

Conclusions

Preoperative anemia is a highly prevalent and modifiable risk factor associated with increased transfusion requirements and adverse perioperative outcomes. The study highlights the importance of implementing patient blood management protocols in surgical practice.

背景：贫血是重大择期手术患者围手术期管理中一种常见且关键的疾病，对术后恢复构成重大风险。本研究旨在评估巴西东北部一所大学医院外科患者术前和术后贫血的患病率。方法：这项回顾性研究包括508名年龄在18岁及以上的患者，他们在2021年10月至2022年10月期间接受了重大择期手术。贫血是根据世界卫生组织的标准定义的（男性血红蛋白< 13 g.dL-1，女性血红蛋白< 12 g.dL-1）。数据从医疗记录中提取，包括术前和术后血红蛋白水平、手术类型和输血需求。结果：508例患者中有59.6%出现术前贫血，女性和男性的平均Hb水平分别为11.66（±/2.75）和11.13（±2.08）g.dL-1。术后贫血率上升至94.6%，女性和男性平均Hb水平分别为9.36（±1.55）g.dL-1和9.49（±1.36）g.dL-1。输血率为总样本的27%。术前贫血患者术中输血的可能性是非贫血患者的4.6倍（OR = 4.58;95% CI: 2.78-7.52; p < 0.001）。术前较高的血红蛋白水平被认为对输血有保护作用（OR = 0.65;95% CI: 0.59-0.72; p < 0.001）。结论：术前贫血是一个非常普遍和可改变的危险因素，与输血需求增加和不良围手术期结果相关。该研究强调了在外科实践中实施患者血液管理方案的重要性。

{"title":"Preoperative and postoperative anemia in major elective surgery: insights from a retrospective cohort in a Brazilian University Hospital","authors":"Lorena dos Santos Goiabeira , Sara Silva Meireles , Allan Santos Silva Leocádio , Heitor J.S. Medeiros , Fernanda Cunha Soares , Aline Macedo Pinheiro , Wallace Andrino da Silva","doi":"10.1016/j.bjane.2025.844715","DOIUrl":"10.1016/j.bjane.2025.844715","url":null,"abstract":"<div><h3>Background</h3><div>Anemia is a common and critical condition in the perioperative management of patients undergoing major elective surgeries, posing significant risks to postoperative recovery. This study aimed to evaluate the prevalence of preoperative and postoperative anemia in surgical patients from a university hospital in northeastern Brazil.</div></div><div><h3>Methods</h3><div>This retrospective study included 508 patients aged 18 years or older who underwent major elective surgeries between October 2021 and October 2022. Anemia was defined according to World Health Organization criteria (hemoglobin < 13 g.dL<sup>-1</sup> for men and < 12 g.dL<sup>-1</sup> for women). Data were extracted from medical records and included preoperative and postoperative hemoglobin levels, surgical types, and transfusion requirements.</div></div><div><h3>Results</h3><div>Preoperative anemia was observed in 59.6% of 508 patients analyzed, with a mean Hb level of 11.66 (±/ 2.75) g.dL<sup>-1</sup> and 11.13 (± 2.08) g.dL<sup>-1</sup> for women and men, respectively. In the postoperative period, the anemia rate increased to 94.6%, with a mean Hb level of 9.36 (± 1.55) g.dL<sup>-1</sup> and 9.49 (± 1.36) g.dL<sup>-1</sup> for women and men, respectively. The transfusion rate was 27% in the total sample. Patients with preoperative anemia were 4.6 times more likely to require intraoperative transfusion compared to non-anemic patients (OR = 4.58; 95% CI: 2.78–7.52; p < 0.001). Higher preoperative hemoglobin levels were identified as protective against transfusion (OR = 0.65; 95% CI: 0.59–0.72; p < 0.001).</div></div><div><h3>Conclusions</h3><div>Preoperative anemia is a highly prevalent and modifiable risk factor associated with increased transfusion requirements and adverse perioperative outcomes. The study highlights the importance of implementing patient blood management protocols in surgical practice.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"76 2","pages":"Article 844715"},"PeriodicalIF":1.9,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Accuracy of a point-of-care CoaguChek test versus standard laboratory coagulation monitoring in cardiac surgery involving cardiopulmonary bypass: randomized clinical trial 在涉及体外循环的心脏手术中，即时CoaguCheck检测与标准实验室凝血监测的准确性随机临床试验。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-11-22 DOI: 10.1016/j.bjane.2025.844714

Fabrício Tavares Mendonça, Sérgio Honorato de Matos, Larissa Goveia Moreira, Igor Louza Pereira, Lorenzo Leite Dino, Matheus Beserra Braga, Gustavo Henrique dos Santos Dias

Background

Intraoperative coagulopathies are common in complex surgeries, and timely coagulation monitoring is crucial. We assessed the accuracy of the point-of-care CoaguChek XS test against standard laboratory measurements in patients undergoing cardiac surgery with Cardiopulmonary Bypass (CPB).

Methods

We conducted a single-center, diagnostic accuracy study to assess the coagulation profile of 50 participants before and after CPB. The index test was the CoaguChek XS device and the reference test was the standard laboratory assay. The primary outcome was the accuracy of the CoaguChek device in measuring the International Normalized Ratio (INR). We pre-specified a tolerance range of ± 0.5 INR units. Secondary outcomes included accuracy in measuring prothrombin time and prothrombin activity.

Results

We included 50 patients undergoing cardiac surgery with CPB between October 2023 and January 2024. The mean (standard deviation) age was 59.2 (12.3) years, and 32 participants (64%) were male. For INR values, Lin’s coefficient was 0.72 (95% CI: 0.60‒0.82) pre-CPB and 0.66 (95% CI: 0.50‒0.77) post-CPB, both indicating good agreement. In the pre-CPB period, on average, the index test readings exceeded reference readings by 0.045 INR units (95% CI: 0.030‒0.059, p < 0.001), while in post-CPB period, index readings were, on average, 0.064 INR units lower (95% CI: -0.09 to -0.04, p < 0.001). Although statistically significant differences were observed, they fell within predefined tolerance range and were considered clinically irrelevant. Analyses of secondary outcomes were consistent with the primary outcome findings.

Conclusion

In patients undergoing cardiac surgery with cardiopulmonary bypass, CoaguChek XS provided results comparable to standard laboratory coagulation monitoring, both pre-and post-cardiopulmonary bypass.

Research Board Approval

Plataforma Brasil CAAE 70266023.8.0000.5553.

Clinical Trials Registration

(https://clinicaltrials.gov/study/NCT06037720) NCT06037720, 14/09/2023.

背景：术中凝血功能障碍在复杂手术中很常见，及时监测凝血功能至关重要。我们对接受心脏手术合并体外循环（CPB）患者的即时护理CoaguChek XS测试与标准实验室测量的准确性进行了评估。方法：我们进行了一项单中心诊断准确性研究，评估50名参与者在CPB前后的凝血状况。指标试验为CoaguChek XS装置，参比试验为标准实验室检测。主要结果是CoaguChek装置测量国际标准化比率（INR）的准确性。我们预先规定了±0.5 INR单位的公差范围。次要结果包括测量凝血酶原时间和凝血酶原活性的准确性。结果：我们纳入了2023年10月至2024年1月期间接受CPB心脏手术的50例患者。平均（标准差）年龄为59.2（12.3）岁，32名参与者（64%）为男性。对于INR值，cpb前的Lin’s系数为0.72 (95% CI: 0.60-0.82)， cpb后的Lin’s系数为0.66 (95% CI: 0.50-0.77)，两者吻合良好。在cpb前，指数测试读数平均超过参考读数0.045个INR单位（95% CI: 0.030-0.059, p < 0.001），而在cpb后时期，指数读数平均低0.064个INR单位（95% CI: -0.09至-0.04,p < 0.001）。虽然观察到统计学上的显著差异，但它们落在预定的耐受范围内，被认为与临床无关。次要结局分析与主要结局结果一致。结论：在接受心脏手术合并体外循环的患者中，CoaguChek XS提供的结果与体外循环术前和术后的标准实验室凝血监测相当。临床试验注册：（https://clinicaltrials.gov/study/NCT06037720） NCT06037720, 2023年9月14日。

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引用次数: 0

Letter to the Editor regarding lateral versus posterior quadratus lumborum block in children undergoing open orchiopexy: a double-blind randomized clinical trial 致编辑的信：关于接受开放性睾丸切除术的儿童腰方肌外侧与后侧阻滞：一项双盲随机临床试验。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-11-21 DOI: 10.1016/j.bjane.2025.844713

Parth Aphale, Himanshu Shekhar, Shashank Dokania

引用次数: 0

Ciprofol versus propofol for sedation in colonoscopy: a systematic review and meta-analysis of randomized controlled trials 环丙酚与异丙酚在结肠镜检查中的镇静作用：随机对照试验的系统回顾和荟萃分析。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-11-17 DOI: 10.1016/j.bjane.2025.844710

Saul Dominici , Italo C. Martins , Breno Dias L. Ribeiro , Victor Arthur Ohannesian , Brunno Braga Sauaia , Abdias Rocha Santos , Caio Márcio Barros de Oliveira , Plínio da Cunha Leal

Background

Ciprofol has emerged as a potential alternative sedative with improved safety and efficacy. However, comparative data for colonoscopy sedation remain limited.

Methods

A systematic search in PubMed, Embase, Cochrane Library, and Web of Science identified RCTs published through August 2025. Studies included patients undergoing colonoscopy using ciprofol or propofol, reporting relevant efficacy or safety outcomes. Risk Ratios (RRs) and Mean Differences (MDs) were calculated using the Mantel-Haenszel random-effects model and 95% Confidence Intervals. The heterogeneity was assessed with I² statistics and Cochrane Q test. Primary outcomes were procedure success rate and patient satisfaction (assessed on a 1-to-10 scale). Secondary outcomes included sedation onset time(s), respiratory depression, injection pain, and hemodynamic adverse events (hypotension and bradycardia). The statistical analyses were performed in R software (version 4.4.1.)

Results

Three RCTs with 645 patients were included. Colonoscopy success rates were similar between ciprofol and propofol (RR = 1.005; 95% CI 0.992–1.019). Ciprofol showed a lower risk of respiratory depression (RR = 0.24; 95% CI 0.08–0.71), injection pain (RR = 0.04; 95% CI 0.01–0.15), and hypotension (RR = 0.85; 95% CI 0.75–0.96). Patient satisfaction was slightly higher with ciprofol (MD = 0.18; 95% CI 0.08–0.29). No significant differences were found in sedation onset time (s) (MD = 2.49s; 95% CI -3.77–8.74) or bradycardia (RR = 0.88; 95% CI 0.44–1.77).

Conclusion

Ciprofol provides comparable efficacy to propofol for colonoscopy sedation, with a lower incidence of respiratory depression, injection pain, and hypotension. Patient satisfaction was slightly higher with ciprofol, while bradycardia occurrence was similar. These findings suggest ciprofol as a promising alternative, though further large-scale studies are needed to confirm its clinical benefits.

背景：环丙酚已成为一种潜在的替代镇静剂，具有更好的安全性和有效性。然而，结肠镜镇静的比较数据仍然有限。方法：系统检索PubMed、Embase、Cochrane Library和Web of Science，确定到2025年8月发表的rct。研究包括使用环丙酚或异丙酚进行结肠镜检查的患者，报告相关的疗效或安全性结果。采用Mantel-Haenszel随机效应模型和95%置信区间计算风险比（rr）和平均差异（md）。采用I²统计量和Cochrane Q检验评估异质性。主要结果是手术成功率和患者满意度（以1到10的量表评估）。次要结局包括镇静起效时间(s)、呼吸抑制、注射疼痛和血流动力学不良事件（低血压和心动过缓）。采用R软件（4.4.1版）进行统计分析。结果：纳入3项随机对照试验，共645例患者。环丙酚和异丙酚结肠镜检查成功率相似（RR = 1.005;95% CI 0.992-1.019）。环丙酚出现呼吸抑制（RR = 0.24;95% CI 0.08-0.71）、注射疼痛（RR = 0.04;95% CI 0.01-0.15）和低血压（RR = 0.85;95% CI 0.75-0.96）的风险较低。环丙酚组患者满意度略高（MD = 0.18;95% CI 0.08-0.29）。镇静起效时间(s) （MD = 2.49s; 95% CI -3.77-8.74）或心动缓（RR = 0.88;95% CI 0.44-1.77）无显著差异。结论：环丙酚用于结肠镜镇静的疗效与异丙酚相当，呼吸抑制、注射疼痛和低血压的发生率较低。环丙酚的患者满意度略高，而心动过缓的发生率相似。这些发现表明环丙酚是一种很有希望的替代品，尽管需要进一步的大规模研究来证实其临床益处。

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引用次数: 0