环泊酚与丙泊酚用于无痛胃肠镜疗效与安全性的Meta分析

Meta-analysis of the efficacy and safety of ciprofol and propofol used in painless gastrointestinal endoscopy

目的系统评估环泊酚与丙泊酚用于无痛胃肠镜镇静的疗效和安全性。方法计算机检索PubMed、Cochrane Library、Embase、中国知网、万方、维普数据库自建库至2022年9月30日发表的关于环泊酚与丙泊酚用于无痛胃肠镜患者的随机对照临床试验,采用RevMan 5.3软件进行Meta分析。结果共纳入5项研究,涉及808例患者。Meta分析结果显示,环泊酚与丙泊酚组在镇静有效率(RR=1.01,95%CI:0.99~1.03,P=0.39)、麻醉诱导时间(WMD=0.38,95%CI:-0.10~0.87,P=0.12)、苏醒时间(WMD=0.88,95%CI:-0.53~2.28,P=0.22)、医师满意率(RR=1.05,95%CI:0.96~1.14,P=0.26)和患者满意率(RR=1.07,95%CI:0.96~1.19,P=0.24)方面差异无统计学意义。环泊酚组麻醉后离院时间(WMD=1.87,95%CI:0.71~3.04,P<0.05)略长于丙泊酚组。在主要不良反应发生率方面,与丙泊酚相比,环泊酚用于无痛胃肠镜具有更低的注射痛(RR=0.09,95%CI:0.05~0.15,P<0.05)、心动过缓(RR=0.10,95%CI:0.06~0.16,P<0.05)、呼吸抑制(RR=0.22,95%CI:0.11~0.42,P<0.05)发生率。结论相比于丙泊酚用于无痛胃肠镜检查,环泊酚镇静有效率、麻醉诱导时间、苏醒时间、医患满意率相当,注射痛、心动过缓、呼吸抑制的发生率更低,可作为无痛胃肠镜镇静较好的药物治疗选择。

Objective To determine the efficacy and safety of ciprofol and propofol in painless gastrointestinal endoscopy patients.Methods The databases of PubMed,Cochrane Library,Embase,CNKI,WanFang and VIP database were retrieved for randomized controlled trials(RCT)of ciprofol and propofol used in painless gastrointestinal endoscopy from inception to September 30,2022.Meta-analysis was conducted with RevMan 5.3 software.Results Totally 5 articles involving 808 patients were included.The meta-analysis showed no significant difference in the sedation success rate[RR=1.01,95%CI:0.99~1.03,P=0.39],anesthesia induction time[WMD=0.38,95%CI:-0.10~0.87,P=0.12],wake-up time[WMD=0.88,95%CI:-0.53~2.28,P=0.22],doctor satisfaction[RR=1.05,95%CI:0.96~1.14,P=0.26]and patient satisfaction[RR=1.07,95%CI:0.96~1.19,P=0.24].The departure time in the ciprofol group was slightly longer than that in the propofol group[WMD=1.87,95%CI:0.71~3.04,P<0.05].In terms of major adverse reactions,ciprofol had lower incidence of injection pain[RR=0.09,95%CI:0.05~0.15,P<0.05],bradycardia[RR=0.10,95%CI:0.06~0.16,P<0.05],and respiratory depression[RR=0.22,95%CI:0.11~0.42,P<0.05].Conclusion In painless gastroenteroscopy,the sedation success rate,anesthesia induction time,wake-up time,doctor and patient satisfaction of ciprofol are similar to those of propofol,while ciprofol has lower incidence of injection pain,bradycardia and respiratory depression.Ciprofol can be used as a better option for sedation in painless gastrointestinal endoscopy.