Comparison of ciprofol and propofol in combination with sufentanil for gastroscopic sedation in people living with obesity: a prospective, randomized, controlled trial.
Summary
In obese patients undergoing gastroscopy with sufentanil-based sedation, ciprofol significantly reduced hypoxemia (19.1% vs 34.3%), apnea (5.9% vs 17.9%), and injection pain (1.5% vs 26.9%) versus propofol, with higher endoscopist satisfaction. These findings suggest ciprofol may offer a safer, more comfortable sedation strategy for high-risk obese patients.
Key Findings
- Hypoxemia occurred less frequently with ciprofol vs propofol (19.1% vs 34.3%; absolute difference 15.2%).
- Apnea episodes were reduced with ciprofol (5.9% vs 17.9%).
- Lower injection pain with ciprofol (1.5% vs 26.9%).
- Higher endoscopist satisfaction and slightly higher minimum SpO2 with ciprofol.
Clinical Implications
For obese patients undergoing gastroscopy, ciprofol may be preferred over propofol to reduce hypoxemia and apnea, improve procedural conditions, and minimize injection pain, potentially enhancing safety and efficiency in endoscopy suites.
Why It Matters
This randomized trial addresses a critical safety issue—respiratory compromise during endoscopy in obesity—and evaluates a next-generation hypnotic (ciprofol) against the standard of care. The large risk reductions in hypoxemia and apnea are clinically meaningful.
Limitations
- Final randomized sample size not explicitly reported in abstract.
- Single-center design may limit generalizability; dosing and monitoring protocols may vary across centers.
Future Directions
Multicenter RCTs with standardized sedation protocols across diverse obese populations and procedures should confirm safety signals, define optimal dosing, and evaluate recovery profiles and cost-effectiveness.
Study Information
- Study Type
- RCT
- Research Domain
- Treatment
- Evidence Level
- I - Randomized controlled trial directly comparing two sedation regimens.
- Study Design
- OTHER