BIS监测下环泊酚与丙泊酚用于老年髋关节置换术术后苏醒的比较

doi:10.12092/j.issn.1009-2501.2026.01.008

中国临床药理学与治疗学 ›› 2026, Vol. 31 ›› Issue (1): 72-77.doi: 10.12092/j.issn.1009-2501.2026.01.008

• 药物治疗学 • 上一篇

BIS监测下环泊酚与丙泊酚用于老年髋关节置换术术后苏醒的比较

张建友¹(), 贡逸¹, 孙鲁瑜¹, 唐苏红¹, 杨大威¹, 周洁²^,*()

1. 扬州大学附属医院麻醉科，扬州大学，扬州 225000，江苏
2. 扬州大学附属医院妇产科，扬州大学，扬州 225000，江苏

收稿日期:2025-03-12 修回日期:2025-09-01 出版日期:2026-01-26 发布日期:2026-02-13
通讯作者: 周洁 E-mail:zhangjianyou@yzu.edu.cn;13049361996@163.com
作者简介:张建友，男，医学博士，主任医师，研究方向：临床麻醉与脏器保护。E-mail：zhangjianyou@yzu.edu.cn
基金资助:
江苏省科技厅社会发展项目（BE2023749）

Comparison of postoperative awakening between ciprofol and propofol in elderly patients undergoing hip replacement under BIS monitoring

Jianyou ZHANG¹(), Yi GONG¹, Luyu SUN¹, Suhong TANG¹, Dawei YANG¹, Jie ZHOU²^,*()

1. Department of Anesthesiology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou 225000, Jiangsu, China
2. Department of Obstetrics and Gynecology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou 225000, Jiangsu, China

Received:2025-03-12 Revised:2025-09-01 Online:2026-01-26 Published:2026-02-13
Contact: Jie ZHOU E-mail:zhangjianyou@yzu.edu.cn;13049361996@163.com

摘要/Abstract

摘要：

目的: 比较环泊酚与丙泊酚持续输注用于老年髋关节置换术术后苏醒的差异。方法: 选取择期行髋关节置换术的老年患者68例，ASA分级Ⅰ-Ⅱ，年龄65～85岁，随机分为两组（n=34）：环泊酚组（C组）和丙泊酚组（P组），C组采用环泊酚0.3 mg/kg、舒芬太尼0.3 μg/kg、顺式阿曲库铵0.15 mg/kg麻醉诱导，持续泵注环泊酚0.8 mg·kg^?1·h^?1，瑞芬太尼1.2～12 μg·kg^?1·h^?1，维持BIS值40～60，维持血压±20%。P组以丙泊酚替换环泊酚，诱导剂量1.5 mg/kg，维持剂量5.0 mg·kg^?1·h^?1。记录术中麻醉药用量、出血量、补液量、尿量、血管活性药使用情况和术中血流动力学指标，术后苏醒时间、自主呼吸恢复时间、拔管时间和改良Aldrete评分≥9分时间，以及拔管后0、5、15、30 min时MOAA/S评分和不良反应。结果: 与P组比较，C组术后苏醒时间、自主呼吸恢复时间、拔管时间显著延长（P<0.05），术中补液量显著减少（P<0.05），尿量显著增加（P<0.05），血管活性药使用例数显著减少（P<0.05）。两组间改良Aldrete评分≥9分时间，以及拔管后0、5、15、30 min时MOAA/S评分和不良反应的比较无统计学差异（P>0.05）。C组瑞芬太尼用量显著增加（P<0.05），术中环泊酚维持剂量为0.849 mg·kg^?1·h^?1（0.456～1.222 mg·kg^?1·h^?1）。结论: 与丙泊酚比较，环泊酚用于老年髋关节置换术术后苏醒时间、自主呼吸恢复时间和拔管时间延长，术中血流动力学更加稳定，环泊酚在老年患者中的维持剂量为0.849 mg·kg^?1·h^?1。

关键词: 环泊酚, 老年患者, 髋关节置换术, 术后苏醒时间

Abstract:

AIM: To compare the difference between ciprofol and propofol continuous infusion for postoperative awakening in elderly patients undergoing hip replacement. METHODS: A total of 68 patients aged 65-85 years, who underwent elective hip replacement surgery were randomly assigned into two groups (n=34 each): group C and group P. In group C, anesthesia was induced with ciprofol 0.3 mg/kg, sufentanil 0.3 μg/kg and cisatracurium 0.15 mg/kg. Anesthesia was then maintained with a continuous infusion of ciprofol at a rate of 0.8 mg·kg^?1·h^?1 and remifentanil at 1.2 to 12 μg·kg^?1·h^?1. The Bispectral Index (BIS) value was kept between 40 and 60, and blood pressure was maintained within ±20% of the baseline. In group P, ciprofol was replaced by propofol at an induction dose of 1.5 mg/kg and a maintenance dose of 5.0 mg·kg^?1·h^?1. Record amount of intraoperative anesthetic dosage, blood loss, volume of fluid input, urine volume, vasoactive drugs usage and intraoperative hemodynamic indexes, postoperative awakening time, spontaneous breathing recovery time, extubation time, and the time required to achieve a modified Aldrete score ≥9, and MOAA/S scores and adverse reactions at 0, 5, 15, and 30 minutes after extubation. RESULTS: Compared to group P, group C exhibited significantly prolonged awakening time, spontaneous breathing recovery time, and extubation time (P<0.05). Additionally, the volume of intraoperative fluid infusion was significantly reduced (P<0.05), urine volume was significantly increased (P<0.05), and the utilization of vasoactive drugs was significantly decreased (P<0.05) in group C. No significant differences were observed between the two groups in terms of the time for modified Aldrete score ≥9, MOAA/S score at 0, 5, 15 and 30 min after extubation, as well as adverse reactions (P>0.05). The dosage of remifentanil in group C showed a significant increase (P<0.05), while the intraoperative maintenance dose of ciprofol was determined to be at a rate of 0.849 mg·kg^?1·h^?1 (range: 0.456 to 1.222 mg·kg^?1·h^?1). CONCLUSION: Compared with propofol, the postoperative awakening time, spontaneous breathing recovery time and extubation time of ciprofol in elderly patients undergoing hip replacement are prolonged, and the intraoperative hemodynamics is more stable. The maintenance dose of ciprofol in elderly patients is 0.849 mg·kg^?1·h^?1.

Key words: ciprofol, elderly patients, hip replacement, postoperative awakening time

中图分类号:

R614

张建友, 贡逸, 孙鲁瑜, 唐苏红, 杨大威, 周洁. BIS监测下环泊酚与丙泊酚用于老年髋关节置换术术后苏醒的比较[J]. 中国临床药理学与治疗学, 2026, 31(1): 72-77.

Jianyou ZHANG, Yi GONG, Luyu SUN, Suhong TANG, Dawei YANG, Jie ZHOU. Comparison of postoperative awakening between ciprofol and propofol in elderly patients undergoing hip replacement under BIS monitoring[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(1): 72-77.

图/表 5

参考文献 20

1	Liao J, Li M, Huang C, et al. Pharmacodynamics and pharmacokinetics of HSK3486, a novel 2, 6-disubstituted phenol derivative as a general anesthetic[J]. Front Pharmacol, 2022, 13, 830791. doi: 10.3389/fphar.2022.830791
2	Wei Y, Qiu G, Lei B, et al. Oral delivery of propofol with methoxymethylphosphonic acid as the delivery vehicle[J]. J Med Chem, 2017, 60 (20): 8580- 8590. doi: 10.1021/acs.jmedchem.7b01133
3	Wang X, Wang X, Liu J, et al. Effects of ciprofol for the induction of general anesthesia in patients scheduled for elective surgery compared to propofol: a phase 3, multicenter, randomized, double-blind, comparative study[J]. Eur Rev Med Pharmacol Sci, 2022, 26 (5): 1607- 1617.
4	Gan TJ, Bertoch T, Habib A, et al. Comparison of the efficacy of HSK3486 and propofol for induction of general anesthesia in adults: a multicenter, randomized, double-blind, controlled, phase 3 noninferiority trial[J]. Anesthesiology, 2023, 140 (4): 690- 700.
5	Liang P, Dai M, Wang X, et al. Efficacy and safety of ciprofol vs. propofol for the induction and maintenance of general anaesthesia: a multicentre, single-blind, randomised, parallel-group, phase 3 clinical trial[J]. Eur J Anaesthesiol, 2023, 40 (6): 399- 406. doi: 10.1097/EJA.0000000000001799
6	Ding YY, Long YQ, Yang HT, et al. Efficacy and safety of ciprofol for general anaesthesia induction in elderly patients undergoing major noncardiac surgery: a randomised controlled pilot trial[J]. Eur J Anaesthesiol, 2022, 39 (12): 960- 963. doi: 10.1097/EJA.0000000000001759
7	Doi M, Morita K, Takeda J, et al. Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase IIb/III trial[J]. J Anesth, 2020, 34 (4): 543- 553. doi: 10.1007/s00540-020-02788-6
8	Page VJ, Ely EW, Gates S, et al. Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): a randomised, double-blind, placebo-controlled trial[J]. Lancet Respir Med, 2013, 1 (7): 515- 523. doi: 10.1016/S2213-2600(13)70166-8
9	Recep B. Comparision Mann-Whitney U Test and Students't Test in terms of type I error rate and test power: A Monte Carlo Simulation Study[J]. AKU J Sci Eng, 2014, 14, 5- 11. doi: 10.5578/fmbd.7380
10	Scott LJ, Perry CM. Remifentanil: a review of its use during the induction and maintenance of general anaesthesia[J]. Drugs, 2005, 65 (13): 1793- 1823. doi: 10.2165/00003495-200565130-00007
11	易强林, 莫怀忠, 胡慧, 等. 环泊酚与丙泊酚在老年患者无痛胃镜检查中的比较[J]. 临床麻醉学杂志, 2022, 38 (7): 712- 715. doi: 10.16662/j.cnki.1674-0742.2024.17.104
12	黄腾, 周脉涛, 张咏梅, 等. BIS监测下丙泊酚与环泊酚闭环靶控输注在老年膝关节置换术中麻醉效果的比较[J]. 中国现代手术学杂志, 2023, 27 (4): 332- 336. doi: 10.16260/j.cnki.1009-2188.2023.04.014
13	张翔, 朱涛. 环泊酚对老年患者无痛胃镜检查时呼吸功能的影响[J]. 临床麻醉学杂志, 2023, 39 (3): 330- 332. doi: 10.12089/jca.2023.03.023
14	Hung KC, Chen JY, Wu SC, et al. A systematic review and meta-analysis comparing the efficacy and safety of ciprofol (HSK3486) versus propofol for anesthetic induction and non-ICU sedation[J]. Front Pharmacol, 2023, 14, 1225288. doi: 10.3389/fphar.2023.1225288
15	Li X, Yang D, Li Q, et al. Safety, pharmacokinetics, and pharmacodynamics of a single bolus of the γ-aminobutyric acid (GABA) receptor potentiator HSK3486 in healthy Chinese elderly and non-elderly[J]. Front Pharmacol, 2021, 27 (12): 735700. doi: 10.3389/fphar.2021.735700
16	Zeng Y, Wang DX, Lin ZM, et al. Efficacy and safety of HSK3486 for the induction and maintenance of general anesthesia in elective surgical patients: a multicenter, randomized, open-label, propofol-controlled phase 2 clinical trial[J]. Eur Rev Med Pharmacol Sci, 2022, 26 (4): 1114- 1124.
17	Liu L, Wang K, Yang Y, et al. Population pharmacokinetic/pharmacodynamic modeling and exposure-response analysis of ciprofol in the induction and maintenance of general anesthesia in patients undergoing elective surgery: a prospective dose optimization study[J]. J Clin Anesth, 2024, 92, 111317. doi: 10.1016/j.jclinane.2023.111317
18	Takechi K, Carstens MI, Klein AH, et al. The antinociceptive and antihyperalgesic effects of topical propofol on dorsal horn neurons in the rat[J]. Anesth Analg, 2013, 116 (4): 932- 938. doi: 10.1213/ANE.0b013e31827f560d
19	Moraga-Cid G, Yevenes GE, Schmalzing G, et al. A Single phenylalanine residue in the main intracellular loop of α1 γ-aminobutyric acid type A and glycine receptors influences their sensitivity to propofol[J]. Anesthesiology, 2011, 115 (3): 464- 473. doi: 10.1097/aln.0b013e31822550f7
20	Man Y, Xiao H, Zhu T, et al. Study on the effectiveness and safety of ciprofol in anesthesia in gynecological day surgery: a randomized double-blind controlled study[J]. BMC Anesthesiol, 2023, 23 (1): 92. doi: 10.1186/s12871-023-02051-x

Item	C group (n=34)	P group (n=31)	χ²/Z/t	P
Gender (Male/Female, n)	16/18	14/17	0.023	0.878
Age [year, M (Q₁, Q₃)]	73.00 (71.00,77.00)	74.00 (67.00,78.25)	0.000	1.000
BMI (kg/m²,$ \overline{x} $±s)	22.11±3.22	23.16±3.29	1.300	0.198
ASA (I/II, n)	8/26	9/22	0.254	0.614
Type of surgery (%)			1.143	0.285
Hemiarthroplasty	20.6	32.3
Total hip replacement	79.4	67.7
Time of surgery (min,$ \overline{x} $±s)	73.12±17.99	74.48±26.41	0.246	0.807
Drug pumping time (min,$ \overline{x} $±s)	88.09±19.88	91.35±25.94	0.573	0.569
Amount of bleeding (mL,$ \overline{x} $±s)	185.29±50.04	213.06±76.43	1.748	0.085
Fluid replacement (mL,$ \overline{x} $±s)	777.94±257.67	959.68±309.41^b	2.581	0.012
Urine volume (mL,$ \overline{x} $±s)	243.53±108.01	189.19±105.47^b	2.049	0.045
Vasoactive drug (with/without, n)	14/20	21/10^b	4.605	0.032

Item	C group (n=34)	P group (n=31)	χ²/Z/t	P
Gender (Male/Female, n)	16/18	14/17	0.023	0.878
Age [year, M (Q₁, Q₃)]	73.00 (71.00,77.00)	74.00 (67.00,78.25)	0.000	1.000
BMI (kg/m²,$ \overline{x} $±s)	22.11±3.22	23.16±3.29	1.300	0.198
ASA (I/II, n)	8/26	9/22	0.254	0.614
Type of surgery (%)			1.143	0.285
Hemiarthroplasty	20.6	32.3
Total hip replacement	79.4	67.7
Time of surgery (min,$ \overline{x} $±s)	73.12±17.99	74.48±26.41	0.246	0.807
Drug pumping time (min,$ \overline{x} $±s)	88.09±19.88	91.35±25.94	0.573	0.569
Amount of bleeding (mL,$ \overline{x} $±s)	185.29±50.04	213.06±76.43	1.748	0.085
Fluid replacement (mL,$ \overline{x} $±s)	777.94±257.67	959.68±309.41^b	2.581	0.012
Urine volume (mL,$ \overline{x} $±s)	243.53±108.01	189.19±105.47^b	2.049	0.045
Vasoactive drug (with/without, n)	14/20	21/10^b	4.605	0.032

Item	C group (n=34)	P group (n=31)	Z/t	P
Awakening time (min)	10.00 (7.00,13.25)	7.00 (5.00,10.00)^b	2.381	0.017
Spontaneous breathing recovery time (min)	8.50 (5.00,12.25)	5.00 (3.00,10.00)^b	2.553	0.011
Extubation time (min)	11.50 (8.00,16.00)	9.00 (7.00,13.00)^b	2.043	0.041
Time to reach a modified Aldrete score ≥ 9 (min,$ \overline{x} $±s)	13.15±5.81	10.77±6.06	1.611	0.112

Item	C group (n=34)	P group (n=31)	Z/t	P
Awakening time (min)	10.00 (7.00,13.25)	7.00 (5.00,10.00)^b	2.381	0.017
Spontaneous breathing recovery time (min)	8.50 (5.00,12.25)	5.00 (3.00,10.00)^b	2.553	0.011
Extubation time (min)	11.50 (8.00,16.00)	9.00 (7.00,13.00)^b	2.043	0.041
Time to reach a modified Aldrete score ≥ 9 (min,$ \overline{x} $±s)	13.15±5.81	10.77±6.06	1.611	0.112

Group	0	5 min	15 min	30 min
C group (n=34)	4 (4,5)	5 (5,5)	5 (5,5)	5 (5,5)
P group (n=31)	4 (4,4)	5 (5,5)	5 (5,5)	5 (5,5)
Z	1.478	1.585	0.955	0.955
P	0.140	0.113	0.340	0.340

BIS监测下环泊酚与丙泊酚用于老年髋关节置换术术后苏醒的比较

Comparison of postoperative awakening between ciprofol and propofol in elderly patients undergoing hip replacement under BIS monitoring

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 5

参考文献 20

相关文章 12

编辑推荐

Metrics

本文评价

Drug	C group (n=34)	P group (n=31)	t	P
Ciprofol (mg·kg^?1·h^?1)	0.849±0.157	?
Propofol (mg·kg^?1·h^?1)	?	4.462±1.003
Remifentanil (μg·kg^?1·h^?1)	5.469±2.811	4.065±2.078^b	2.272	0.027

Item	Timing	C group (n=34)	P group (n=31)	t	P
HR	T0	75.7±13.2	78.7±11.4	?0.810	0.421
	T1	68.2±13.2	67.8±11.4	1.239	0.220
	T2	63.5±10.0	62.2±7.2	1.400	0.166
	T3	65.7±10.9	64.2±9.8	1.508	0.137
MAP	T0	102.8±11.9	105.0±10.2	?0.990	0.326
	T1	92.6±17.2	87.9±12.9	0.110	0.913
	T2	92.5±12.4	88.1±12.6	0.570	0.571
	T3	92.9±11.5	88.5±11.9	0.584	0.561

[1]	张从利, 闫妍, 宋楠楠, 刘娣, 张阳, 周平辉, 任丽, 范方田. 艾司氯胺酮对后路腰椎融合术老年患者术后疲劳综合征的影响[J]. 中国临床药理学与治疗学, 2026, 31(1): 63-71.
[2]	陆方舟, 刘美娟, 曾琼, 章文斌, 陆军. 环泊酚复合舒芬太尼在颅内动脉瘤栓塞术患者中抑制气管插管反应的半数有效剂量[J]. 中国临床药理学与治疗学, 2025, 30(8): 1092-1098.
[3]	华豪, 何滕, 李鑫, 陈晓东, 刘祯庆, 刘坤, 张琪, 姜琳, 刘存明, 王猛, 杨春. 艾司氯胺酮主导无阿片麻醉对老年患者全髋关节置换术术后谵妄的影响[J]. 中国临床药理学与治疗学, 2025, 30(1): 78-84.
[4]	段功宸, 吴继敏, 徐巧敏, 江建鑫, 蓝海燕, 张旭彤, 袁开明, 李军. 瑞马唑仑对髋部骨折老年患者术后早期认知功能的影响[J]. 中国临床药理学与治疗学, 2024, 29(2): 146-153.
[5]	董力, 周枫. 甲苯磺酸瑞马唑仑联合瑞芬太尼麻醉对老年脊柱外科手术患者血流动力学和血清炎症因子水平的影响[J]. 中国临床药理学与治疗学, 2023, 28(12): 1372-1377.
[6]	卢克鹏, 刘彩虹, 毕莹. 预防性抗凝持续时间对全髋/膝关节置换术后静脉血栓形成的影响[J]. 中国临床药理学与治疗学, 2023, 28(11): 1269-1274.
[7]	贾博颖, 周双, 万里燕, 周颖, 崔一民. 基于FAERS的老年患者药源性吞咽障碍信号挖掘研究[J]. 中国临床药理学与治疗学, 2023, 28(10): 1109-1120.
[8]	贾博颖, 周双, 周颖, 崔一民. 基于STOPPFrail标准的衰弱老年患者潜在不合理用药的横断面研究[J]. 中国临床药理学与治疗学, 2020, 25(8): 916-925.
[9]	黄巧文，蔡丽生. 右美托咪定对全麻下老年患者腹腔镜结直肠癌手术的应激水平和术后细胞因子影响[J]. 中国临床药理学与治疗学, 2016, 21(7): 802-805.
[10]	杨维佳，姚惠，郑培奋，王丽君，杨敏春. 健脾益气养血法对老年营养不良患者小分子代谢物质的影响[J]. 中国临床药理学与治疗学, 2016, 21(12): 1378-1383.
[11]	杨云丽, 魏辉明, 张承华, 贺焱峰, 鲁成润. 氯诺昔康对老年患者全髋置换术后舒芬太尼皮下自控镇痛效果的影响[J]. 中国临床药理学与治疗学, 2014, 19(2): 190-195.
[12]	王尔华, 蔡定球, 陶佳, 崔士和, 马正良. 艾司洛尔降低老年患者全身麻醉中芬太尼用量及安全性探讨[J]. 中国临床药理学与治疗学, 2008, 13(10): 1173-1176.