Exploring the Median Effective Dose of Ciprofol for Anesthesia Induction in Elderly Patients: Impact of Frailty on ED₅₀

References

• Schnider TW, Minto CF, Shafer SL, et al. The influence of age on propofol pharmacodynamics. Anesthesiology. 1999;90(6):1502–1516. doi:10.1097/00000542-199906000-00003
   PubMed Web of Science ®Google Scholar
• 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. Front Pharmacol. 2021;12:735700. doi:10.3389/fphar.2021.735700
   PubMed Web of Science ®Google Scholar
• Gottesman D, McIsaac DI. Frailty and emergency surgery: identification and evidence-based care for vulnerable older adults. Anaesthesia. 2022;77(12):1430–1438. doi:10.1111/anae.15860
   PubMed Web of Science ®Google Scholar
• Ching S, Purdon PL, Vijayan S, Kopell NJ, Brown EN. A neurophysiological-metabolic model for burst suppression. Proc Natl Acad Sci U S A. 2012;109(8):3095–3100. doi:10.1073/pnas.1121461109
   PubMed Web of Science ®Google Scholar
• Protasi F, Pietrangelo L, Boncompagni S. Improper remodeling of organelles deputed to Ca(2+) handling and aerobic ATP production underlies muscle dysfunction in ageing. Int J Mol Sci. 2021;22(12):6195. doi:10.3390/ijms22126195
   PubMed Web of Science ®Google Scholar
• Kreuzer M, Butovas S, García PS, et al. Propofol affects cortico-hippocampal interactions via β3 subunit-containing GABA(A) receptors. Int J Mol Sci. 2020;21(16). doi:10.3390/ijms21165844.
   Web of Science ®Google Scholar
• Sahinovic MM, Struys M, Absalom AR. Clinical pharmacokinetics and pharmacodynamics of propofol. Clin Pharmacokinet. 2018;57(12):1539–1558. doi:10.1007/s40262-018-0672-3
   PubMed Web of Science ®Google Scholar
• Farhan M, Hoda MQ, Ullah H. Prevention of hypotension associated with the induction dose of propofol: a randomized controlled trial comparing equipotent doses of phenylephrine and ephedrine. J Anaesthesiol Clin Pharmacol. 2015;31(4):526–530. doi:10.4103/0970-9185.169083
   PubMedGoogle Scholar
• Phillips AT, Deiner S, Mo Lin H, Andreopoulos E, Silverstein J, Levin MA. Propofol use in the elderly population: prevalence of overdose and association with 30-day mortality. Clin Ther. 2015;37(12):2676–2685. doi:10.1016/j.clinthera.2015.10.005
   PubMed Web of Science ®Google Scholar
• Tan CH, Onsiong MK. Pain on injection of propofol. Anaesthesia. 1998;53(5):468–476. doi:10.1046/j.1365-2044.1998.00405.x
   PubMed Web of Science ®Google Scholar
• 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. Eur J Anaesthesiol. 2023;40(6):399–406. doi:10.1097/EJA.0000000000001799
   PubMed Web of Science ®Google Scholar
• Liu Y, Yu X, Zhu D, et al. Safety and efficacy of ciprofol vs. propofol for sedation in intensive care unit patients with mechanical ventilation: a multi-center, open label, randomized, Phase 2 trial. Chin Med J. 2022;135(9):1043–1051. doi:10.1097/CM9.0000000000001912
   PubMed Web of Science ®Google Scholar
• Chen X, Guo P, Yang L, Liu Z, Yu D. Comparison and clinical value of ciprofol and propofol in intraoperative adverse reactions, operation, resuscitation, and satisfaction of patients under painless gastroenteroscopy anesthesia. Contrast Media Mol Imaging. 2022;2022:9541060. doi:10.1155/2022/9541060
   PubMed Web of Science ®Google Scholar
• Liu Y, Peng Z, Liu S, et al. Efficacy and safety of ciprofol sedation in ICU patients undergoing mechanical ventilation: a multicenter, single-blind, randomized, noninferiority trial. Crit Care Med. 2023;51(10):1318–1327. doi:10.1097/CCM.0000000000005920
   PubMed Web of Science ®Google Scholar
• World Medical Association. World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194. doi:10.1001/jama.2013.281053
   PubMed Web of Science ®Google Scholar
• Liang YD, Zhang YN, Li YM, et al. Identification of frailty and its risk factors in elderly hospitalized patients from different wards: a cross-sectional study in China. Clin Interv Aging. 2019;14:2249–2259. doi:10.2147/CIA.S225149
   PubMed Web of Science ®Google Scholar
• Chou YC, Tsou HH, Chan DD, et al. Validation of clinical frailty scale in Chinese translation. BMC Geriatr. 2022;22(1):604. doi:10.1186/s12877-022-03287-x
   PubMed Web of Science ®Google Scholar
• Dixon WJ. Staircase bioassay: the up-and-down method. Neurosci Biobehav Rev. 1991;15(1):47–50. doi:10.1016/S0149-7634(05)80090-9
   PubMed Web of Science ®Google Scholar
• Pace NL, Stylianou MP, Warltier DC. Advances in and limitations of up-and-down methodology: a précis of clinical use, study design, and dose estimation in anesthesia research. Anesthesiology. 2007;107(1):144–152. doi:10.1097/01.anes.0000267514.42592.2a
   PubMed Web of Science ®Google Scholar
• Dodds C. Anaesthetic drugs in the elderly. Pharmacol Ther. 1995;66(2):369–386. doi:10.1016/0163-7258(94)00070-J
   PubMed Web of Science ®Google Scholar
• Chen WT, Chou KH, Liu LK, et al. Reduced cerebellar gray matter is a neural signature of physical frailty. Hum Brain Mapp. 2015;36(9):3666–3676. doi:10.1002/hbm.22870
   PubMed Web of Science ®Google Scholar
• Beishon L, Clough RH, Kadicheeni M, et al. Vascular and haemodynamic issues of brain ageing. Pflugers Arch. 2021;473(5):735–751. doi:10.1007/s00424-020-02508-9
   PubMed Web of Science ®Google Scholar
• Kruijt Spanjer MR, Bakker NA, Absalom AR. Pharmacology in the elderly and newer anaesthesia drugs. Best Pract Res Clin Anaesthesiol. 2011;25(3):355–365. doi:10.1016/j.bpa.2011.06.002
   PubMedGoogle Scholar
• Caspary DM, Hughes LF, Ling LL. Age-related GABAA receptor changes in rat auditory cortex. Neurobiol Aging. 2013;34(5):1486–1496. doi:10.1016/j.neurobiolaging.2012.11.009
   PubMed Web of Science ®Google Scholar
• Taylor JA, Greenhaff PL, Bartlett DB, Jackson TA, Duggal NA, Lord JM. Multisystem physiological perspective of human frailty and its modulation by physical activity. Physiol Rev. 2023;103(2):1137–1191. doi:10.1152/physrev.00037.2021
   PubMed Web of Science ®Google Scholar
• Kanto J, Gepts E. Pharmacokinetic implications for the clinical use of propofol. Clin Pharmacokinet. 1989;17(5):308–326. doi:10.2165/00003088-198917050-00002
   PubMed Web of Science ®Google Scholar
• Coetzee E, Absalom AR. Pharmacokinetic and pharmacodynamic changes in the elderly: impact on anesthetics. Anesthesiol Clin. 2023;41(3):549–565. doi:10.1016/j.anclin.2023.02.006
   PubMedGoogle Scholar
• Quan X, Yi J, Ye TH, et al. Propofol and memory: a study using a process dissociation procedure and functional magnetic resonance imaging. Anaesthesia. 2013;68(4):391–399. doi:10.1111/anae.12147
   PubMed Web of Science ®Google Scholar
• Naguib M, Sari-Kouzel A, Seraj M, el-Gammal M, Gomma M. Induction dose-responses studies with propofol and thiopentone. Br J Anaesth. 1992;68(3):308–310. doi:10.1093/bja/68.3.308
   PubMed Web of Science ®Google Scholar
• Ding YY, Long YQ, Yang HT, Zhuang K, Ji FH, Peng K. Efficacy and safety of ciprofol for general anaesthesia induction in elderly patients undergoing major noncardiac surgery: a randomised controlled pilot trial. Eur J Anaesthesiol. 2022;39(12):960–963. doi:10.1097/EJA.0000000000001759
   PubMed Web of Science ®Google Scholar
• Görges M, Zhou G, Brant R, Ansermino JM. Sequential allocation trial design in anesthesia: an introduction to methods, modeling, and clinical applications. Paediatr Anaesth. 2017;27(3):240–247. doi:10.1111/pan.13088
   PubMed Web of Science ®Google Scholar
• Oron AP, Souter MJ, Flournoy N. Understanding research methods: up-and-down designs for dose-finding. Anesthesiology. 2022;137(2):137–150. doi:10.1097/ALN.0000000000004282
   PubMed Web of Science ®Google Scholar
• Choi JY, Kim KI, Choi Y, et al. Comparison of multidimensional frailty score, grip strength, and gait speed in older surgical patients. J Cachexia Sarcopenia Muscle. 2020;11(2):432–440. doi:10.1002/jcsm.12509
   PubMed Web of Science ®Google Scholar
• Varley PR, Buchanan D, Bilderback A, et al. Association of routine preoperative frailty assessment with 1-year postoperative mortality. JAMA Surg. 2023;158(5):475–483. doi:10.1001/jamasurg.2022.8341
   PubMed Web of Science ®Google Scholar
• Kopp VJ. Use of the American society of anesthesiologists physical status classification system in research. Anesth Analg. 2013;117(3):752. doi:10.1213/ANE.0b013e31829ec1bc
   PubMed Web of Science ®Google Scholar
• AmericanSocietyofAnesthesiologists. Statement on ASA physical status classification system. [EB/OL]. http://www.asahq.org/resources/clinical-information/asa-physical-status-classification-system.Accessed March 27, 2024)..
   Google Scholar
• Mayhew D, Mendonca V, Murthy BVS. A review of ASA physical status - historical perspectives and modern developments. Anaesthesia. 2019;74(3):373–379. doi:10.1111/anae.14569
   PubMed Web of Science ®Google Scholar
• Horvath B, Kloesel B, Todd MM, Cole DJ, Prielipp RC. The evolution, current value, and future of the American society of anesthesiologists physical status classification system. Anesthesiology. 2021;135(5):904–919. doi:10.1097/ALN.0000000000003947
   PubMed Web of Science ®Google Scholar
• Aissaoui Y, Jozwiak M, Bahi M, et al. Prediction of post-induction hypotension by point-of-care echocardiography: a prospective observational study. Anaesth Crit Care Pain Med. 2022;41(4):101090. doi:10.1016/j.accpm.2022.101090
   PubMed Web of Science ®Google Scholar
• Lan H, Shan W, Wu Y, et al. Efficacy and safety of ciprofol for sedation/anesthesia in patients undergoing hysteroscopy: a randomized, parallel-group, controlled trial. Drug Des Devel Ther. 2023;17:1707–1717. doi:10.2147/DDDT.S414243
   PubMed Web of Science ®Google Scholar
• McDougall SJ, Bailey TW, Mendelowitz D, Andresen MC. Propofol enhances both tonic and phasic inhibitory currents in second-order neurons of the solitary tract nucleus (NTS). Neuropharmacology. 2008;54(3):552–563. doi:10.1016/j.neuropharm.2007.11.001
   PubMed Web of Science ®Google Scholar
• Zhong J, Zhang J, Fan Y, et al. Efficacy and safety of ciprofol for procedural sedation and anesthesia in non-operating room settings. J Clin Anesth. 2023;85:111047. doi:10.1016/j.jclinane.2022.111047
   PubMed Web of Science ®Google Scholar