Comparison Of The Effect Of Ciprofol And Propofol On Blood Coagulation Functions In Patients With Type 2 Diabetes During Induction Of General Anesthesia

Objective:To compare the effect of ciprofol and propofol on the coagulation function of patients with type 2 diabetes during the induction period of general anesthesia,to predict whether ciprofol can better improve the hypercoagulation state of patients with surgical trauma compared with propofol,and to provide scientific basis and reference for its application in clinical practice.Methods:A total of 60 patients with type 2 diabetes mellitus scheduled for elective surgery under general anesthesia in the First Hospital of Shanxi Medical University from October 2021 to Aμ gust 2022 were selected,including 29 males and 31 females,aged 40-80 years,with BMI of 18-25 kg/m2.The patients were randomly divided into two groups by random number table method: cyclopropofol group and propofol group.General anesthesia induction :In group H,intravenous injected fentanyl 3μ g/kg,cis-atracurium 0.2mg/kg,ciprofol 0.4 mg/kg.In Group P,intravenous injected fentanyl 3μg/kg,cis-atracurium 0.2mg/kg and propofol 2 mg/kg.The maintenance of anesthesia was the same in two groups.Both groups were target-controlled infusion of remifentanil in dose of 0.1-0.2μg/(kg·min)and sevoflurane in dose of 0.5%-3%.Blood samples were collected from the radial artery before induction of anesthesia(T0),immediately before endotracheal intubation(T1),after endotracheal intubation 1 min(T2),5min(T3)and 10min(T4)for determination of plasma TXB2,ET-1,and D-dimer.Elbow venous blood samples were collected at before anesthesia and 15 minutes after anesthesia induction for thrombelastogram R,K,MA and Angle values.Results:(1).There was no significant differences in each index between the two gro ups at different time points(TXB2:FInteraction =0.769,P=0.556;ET-1:FInteraction=0.578,P =0.681;D-dime:FInteraction=0.385,P=0.817).Compared with T0 and T1,the conce ntration of plasma TXB2,ET-1 and D-dimer were obviously increased after trac heal intubation in two groups at T2-T4,and T2 was significantly higher than T3,and T3 was significantly higher than T4(TXB2:Ftime=170.588,P <0.001;ET-1:Fti me=94.273,P <0.001;D-dimer:Ftime=144.693,P <0.001).(2).At 15 min after induction of anesthesia,the R and K values increased,while the MA and Angle values decreased(P <0.05),and there was no signific ant differences between groups(P >0.05).(3).The incidence of hypotension(13.33%vs36.67%),bradycardia(6.67%vs26.67%)and injection pain(6.67%vs33.33%)in the cyclopropofol group was signific antly lower than that in the propofol group(P < 0.05).Conclusion:Both propofol and cyclopofol can effectively inhibit the release of TXB2,ET-1 and D-dimer and improve the hypercoagulability in patients with type 2 diab etes mellitus.However,compared with propofol,cyclopropofol can significantly reduce the incidence of perioperative related adverse reactions.Therefore,cyclop ropofol may be a more appropriate choice for anesthesia induction in patients w ith type 2 diabetes mellitus,especially those with microvascular diseases.