关键词: 环泊酚, 老年, 纤维支气管镜

Abstract:

Objective To evaluate the safety and efficacy of ciprofol in the anesthesia of elderly patients undergoing bronchoscopy. Methods A total of 96 elderly patients （≥ 65 years old） undergoing fiberoptic bronchoscopy under sedation and anesthesia were randomly assigned to either the ciprofol group （Group C， n = 48） or the propofol group （Group P， n = 48）. In Group C， anesthesia was induced with an intravenous injection of sufentanil at 0.1 μg/kg and ciprofol at 0.3 mg/kg. In Group P， anesthesia was induced with an intravenous injection of sufentanil at 0.1 μg/kg and propofol medium/long-chain fat emulsion at 1.5 mg/kg. Hemodynamic parameters， including heart rate （HR）， mean arterial pressure （MAP）， and peripheral oxygen saturation （SpO₂）， were recorded at five time points： before anesthesia induction （T₁）， immediately after the bronchoscope passed through the glottis （T₂）， immediately after it reached the carina （T₃）， immediately after the bronchoscope was withdrawn from the nostril post-procedure （T₄）， and upon full consciousness after leaving the recovery room （T₅）. Additionally， the success rate of sedation and anesthesia， cough severity scores， induction time （t₁）， bronchoscopy duration （t₂）， recovery time （t₃）， and orientation recovery time （t₄） were documented for both groups. Intraoperative complications， such as hypotension， hypoxemia （SpO₂ < 90%）， injection pain during induction， airway interventions （e.g.， jaw support， mask ventilation）， and the number of additional sedative doses administered， were also recorded. Results Compared with T₁， MAP in both groups decreased at T₂ and T₃ （P < 0.05）. Compared with group P， group C exhibited a higher MAP at T₂ and T₃ （P < 0.05）. between the two groups in terms of sedation success rate， induction time， cough score， examination time， recovery time， and orientation recovery time （P > 0.05）. Compared with group P， group C demonstrated lower incidences of hypotension， hypoxemia， injection pain， and fewer airway intervention events （P < 0.05）. Conclusions Compared with propofol， ciprofol in combination with sufentanil demonstrates superior circulatory stability， a lower incidence of respiratory system-related adverse reactions， and reduced injection pain. Therefore， it can be safely and effectively utilized for painless bronchoscopic diagnosis and treatment in elderly patients.

Key words: ciprofol, elderly, fibrobronchoscopy