Comparison of Ciprofol, Remimazolam, and Propofol on Arrhythmia Inducibility in Pediatric Supraventricular Tachycardia: A Retrospective Study

Xu Zhang,1,* Ning Zhang,2,* Kuiliang Wang,3 Yueyi Ren3 1Department of Anesthesiology, Peking University People’s Hospital, Qingdao; Women and Children’s Hospital, Qingdao University, Qingdao, People’s Republic of China; 2Department of Laboratory Medicine, Qingdao Women’s and Children’s Hospital Afftiliated to Qingdao University, Qingdao, People’s Republic of China; 3Department of Anesthesiology, Qingdao Women’s and Children’s Hospital Afftiliated to Qingdao University, Qingdao, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yueyi Ren, Email [email protected] Kuiliang Wang, Email [email protected]: Propofol is a commonly used intravenous anesthetic in pediatric patients. Ciprofol and remimazolam, newly approved agents, cause minimal injection pain and demonstrate stable hemodynamic characteristics. This study aimed to evaluate their effects on arrhythmia inducibility in pediatric supraventricular tachycardia (SVT).Patients and Methods: A retrospective analysis was conducted on the clinical data of pediatric patients with supraventricular tachycardia who underwent radiofrequency ablation under general anesthesia from May 2020 to June 2024. After excluding 28 cases, 173 patients were deemed eligible for analysis. According to the intravenous anesthesia drugs administered, the patients were classified into the propofol group (Group P), the ciprofol group (Group C), and the remimazolam group (Group R). The primary outcome measure was the arrhythmia inducibility, while the secondary outcome measures encompassed ablation success, extubation time, bispectral index (BIS) value, peri - operative relevant parameters, and the incidence of postoperative nausea and vomiting.Results: No significant difference was observed in the arrhythmia inducibility among the three groups (97.40% vs 95.35% vs 94.34%) (P> 0.05). The secondary outcome measures in the three groups, including ablation success (P > 0.05), isoprenaline use (P > 0.05), recurrence (P > 0.05) and operation time (P > 0.05), were similar. Additionally, there was no significant difference in the incidence rates of nausea and vomiting. Excluding the baseline BIS, the Bispectral Index values of Group R were significantly higher than those of Group P and Group C at the same time point (P< 0.05). Moreover, the extubation time in Group R was shorter than that in Group P and Group C.Conclusion: The effects of ciprofol and remimazolam on arrhythmia inducibility in pediatric supraventricular tachycardia were comparable to those of propofol. Both ciprofol and remimazolam are appropriate for radiofrequency ablation of supraventricular tachycardia in pediatric patients.Keywords: arrhythmia inducibility, ciprofol, pediatric, radiofrequency ablation, remimazolam, supraventricular tachycardia