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探索丙泊酚的替代药物:静脉麻醉选择的全面综述。

Exploring Ciprofol Alternatives: A Comprehensive Review of Intravenous Anesthesia Options.

作者信息

Durai Samy Nandha Kumar, Taksande Karuna

机构信息

Anaesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

出版信息

Cureus. 2024 Apr 4;16(4):e57581. doi: 10.7759/cureus.57581. eCollection 2024 Apr.

Abstract

Ciprofol is a recently developed, short-acting γ-aminobutyric acid receptor agonist sedative that is more potent than propofol. Still, there have been few clinical studies of this agent to date. This review explores alternative intravenous anesthesia options to ciprofol, considering their pharmacology, clinical efficacy, safety profile, and practical considerations. While ciprofol offers advantages such as rapid onset and predictable offset, concerns regarding its safety profile and individual variability in response have prompted the search for alternatives. Propofol, etomidate, ketamine, and dexmedetomidine are discussed as established options, each with unique characteristics and potential benefits. Emerging agents, including remimazolam, sufentanil, alfaxalone, and brexanolone, are examined for their potential role in anesthesia management. Recommendations for future research include large-scale comparative studies, optimization of dosing strategies, and personalized approaches guided by pharmacogenomic insights. Ultimately, the future of intravenous anesthesia lies in a multifaceted approach that integrates evidence-based practices, technological innovations, and individualized patient care to enhance safety, efficacy, and patient satisfaction across the perioperative continuum. Collaboration among stakeholders will be crucial in advancing the field and shaping the future landscape of intravenous anesthesia options.

摘要

环丙泊酚是一种最近研发的短效γ-氨基丁酸受体激动剂镇静剂,其效力比丙泊酚更强。尽管如此,迄今为止针对该药物的临床研究仍较少。本综述探讨了环丙泊酚之外的其他静脉麻醉选择,考量了它们的药理学、临床疗效、安全性概况及实际注意事项。虽然环丙泊酚具有起效迅速和作用时间可预测等优点,但其安全性概况及个体反应差异引发了人们对寻找替代药物的关注。丙泊酚、依托咪酯、氯胺酮和右美托咪定作为已确立的选择进行了讨论,每种药物都有独特的特性和潜在益处。还研究了包括瑞马唑仑、舒芬太尼、阿法沙龙和布雷沙诺龙在内的新型药物在麻醉管理中的潜在作用。对未来研究的建议包括大规模比较研究、给药策略的优化以及基于药物基因组学见解的个性化方法。最终,静脉麻醉的未来在于多方面的方法,整合循证实践、技术创新和个体化患者护理,以提高围手术期全过程的安全性、疗效和患者满意度。利益相关者之间的合作对于推动该领域发展并塑造静脉麻醉选择的未来格局至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/223a/11069617/a85b05554d4b/cureus-0016-00000057581-i01.jpg

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