Efficacy and safety of Ciprofol compared with Propofol during general anesthesia induction : A systematic review and meta-analysis of randomized controlled trials (RCT)

Copyright © 2024 Elsevier Inc. All rights reserved..

BACKGROUND: Ciprofol, a newer entrant with similarities to propofol, has shown promise with a potentially improved safety profile, making it an attractive alternative for induction of general anesthesia. This meta-analysis aimed to assess the safety and efficacy of ciprofol compared with propofol during general anesthesia induction.

METHODS: A comprehensive literature search was conducted using PubMed, Clinical Trial.gov, and Cochrane Library databases from inception to July 2023 to identify relevant studies. All statistical analyses were conducted using R statistical software version 4.1.2.

RESULTS: Thirteen Randomized Controlled Trials (RCTs) encompassing a total of 1998 participants, were included in our analysis. The pooled analysis indicated that Ciprofol was associated with a notably lower incidence of pain upon injection [RR: 0.15; 95% CI: 0.10 to 0.23; I^2 = 43%, p < 0.0000001] and was non-inferior to propofol in terms of anesthesia success rate [RR: 1.00; 95% CI: 0.99 to 1.01; I^2 = 0%; p = 0.43]. In terms of safety, the incidence of hypotension was significantly lower in the ciprofol group [RR:0.82; 95% CI:0.68 to 0.98; I^2 = 48%; p = 0.03]. However, no statistically significant differences were found for postoperative hypertension, bradycardia, or tachycardia.

CONCLUSION: In conclusion, Ciprofol is not inferior to Propofol in terms of its effectiveness in general anesthesia. Ciprofol emerges as a valuable alternative sedative with fewer side effects, especially reduced injection pain, when compared to Propofol.

SUMMARY: Propofol, frequently utilized as an anesthetic, provides swift onset and quick recovery. However, it has drawbacks such as a narrow effective dosage range and a high occurrence of adverse effects, particularly pain upon injection. Ciprofol, a more recent drug with propofol-like properties, has demonstrated promise and may have an improved safety profile, making it a compelling alternative for inducing general anesthesia. This meta-analysis compared the safety and effectiveness of Ciprofol with Propofol for general anesthesia induction in a range of medical procedures, encompassing thirteen Randomized Controlled Trials (RCTs) and 1998 individuals. The pooled analysis indicated that Ciprofol was associated with a notably lower incidence of pain upon injection [RR: 0.15; 95% CI: 0.10 to 0.23; I^2 = 43%, p < 0.0000001] and was non-inferior to propofol in terms of anesthesia success rate [RR: 1.00; 95% CI: 0.99 to 1.01; I^2 = 0%; p = 0.43]. In terms of safety, the incidence of hypotension was significantly lower in the ciprofol group [RR:0.82; 95% CI:0.68 to 0.98; I^2 = 48%; p = 0.03]. However, no statistically significant differences were found for hypertension, bradycardia, or tachycardia. In conclusion, ciprofol is equally effective at inducing and maintaining general anesthesia as propofol. When compared to propofol, ciprofol is a better alternative sedative for operations including fiberoptic bronchoscopy, gynecological procedures, gastrointestinal endoscopic procedures, and elective surgeries because it has less adverse effects, most notably less painful injections.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:94

Enthalten in:

Journal of clinical anesthesia - 94(2024) vom: 01. Apr., Seite 111425

Sprache:

Englisch

Beteiligte Personen:

Akhtar, Syed Muhammad Muneeb [VerfasserIn]
Fareed, Areeba [VerfasserIn]
Ali, Mirha [VerfasserIn]
Khan, Muhammad Sohaib [VerfasserIn]
Ali, Abraish [VerfasserIn]
Mumtaz, Munazza [VerfasserIn]
Kirchoff, Robert [VerfasserIn]
Asghar, Muhammad Sohaib [VerfasserIn]

Links:

Volltext

Themen:

Anesthesia efficacy
Anesthesia induction
Anesthetics, Intravenous
Ciprofol
Efficacy
General anesthesia
Injection pain
Journal Article
Meta-Analysis
Meta-analysis
Propofol
Safety
Systematic Review
YI7VU623SF

Anmerkungen:

Date Completed 11.03.2024

Date Revised 04.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.jclinane.2024.111425

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369025520