Effects of ciprofol on postoperative delirium and early rehabilitation in elderly patients undergoing thoracoscopic radical resection of lung cancer
Objective To investigate the effects of ciprofol for induction and maintenance of general anesthesia on post-operative delirium(POD)and early rehabilitation in elderly patients undergoing thoracoscopic radical resection of lung cancer.Methods Henan Provincial Chest Hospital recruited 220 elderly patients aged 65 to 79 for planned thoracoscop-ic lung cancer radical surgery from May 2023 to February 2024.These 220 patients were randomly allocated into two groups using a random number table:propofol group(group C)and ciprofol group(group P),with each group consis-ting of 110 cases.Ciprofol 0.3 mg/kg was injected intravenously during anesthesia induction in the group C,and cipro-fol 0.6-1.8 mg/(kg·h)was pumped intravenously during anesthesia maintenance;the patients of the group P was in-travenously injected with propofol 2.0 mg/kg during anesthesia induction,and intravenous infusion of propofol 4.0-12.0 mg/(kg·h)was administrating during anesthesia maintenance.The rest of the anesthesia induction and maintenance medication were the same between the two groups.The occurrence of POD within 3 d after surgery was assessed using the confusion assessment method for the intensive care unit(CAM-ICU).The quality of recovery was assessed on the first and second postoperative day using the 15-item quality of recovery questionnaire(QoR-15).The time of first ambulation and postoperative hospital stay,blood routine before operation and on 1 d and 3 d after operation,and the incidence of intraoperative and postoperative complications inclu-ding sinus bradycardia or hypotension/hypertension and postoperative infection were statistically analyzed.Results Within 3 d after operation,POD occurred in 19 patients(17.3％)and 35 patients(31.8％)in group C and group P,respectively,while POD did not occur in 91 patients(82.7％)and 75 patients(68.2％).The study results showed that the incidence of POD in group C was significantly lower than that in group P(P＜0.05).In compar-ison to the group P,patients in the group C showed significantly increased QoR-15 scores on 1 d and 2 d postoperative-ly(P＜0.05),along with a notable reduction in time to first ambulation(P＜0.05).Additionally,the group C exhibi-ted a significant decrease in white blood cell count,neutrophil count,and percentage of neutrophils on 1 d and 3 d after surgery(P＜0.05).The incidence of sinus bradycardia and hypotension during surgery was also significantly lower in the group C(P＜0.05).Conclusion Compared with propofol,ciprofol for induction and maintenance of general anes-thesia does not increase the incidence of POD in elderly patients undergoing thoracoscopic radical resection of lung canc-er,and improve early clinical outcomes.
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