Efficacy and safety of Ciprofol for procedural sedation and anesthesia in non-operating room settings

Study objective: Ciprofol, a novel intravenous anesthetic, provides rapid recovery in patients undergoing colo-noscopy. We aimed to examine the efficacy and safety of ciprofol in comparison with propofol for sedation or anesthesia in non-operating room settings including endoscopic submucosal dissection, endoscopic retrograde cholangiopancreatography, and flexible bronchoscopy (FB). Design: Prospective, randomized, double-blind, parallel-group clinical trial. Setting: University-affiliated teaching hospital. Patients: We recruited 207 patients scheduled for an endoscopic procedure from October 2021 to December 2021. Interventions: Patients were randomized into three groups according to the dose during induction (n = 69 each): 1) ciprofol 6 mg/kg/h, 2) ciprofol 8 mg/kg/h, or 3) propofol 40 mg/kg/h. Ciprofol or propofol was administered throughout the procedure. Measurements: The primary outcome was the success rate of sedation or anesthesia for the procedures. Secondary outcomes included induction time, endoscope insertion time, recovery time, discharge time, incidence of drug -related adverse events (AEs), neurological and inflammatory outcomes. Main results: The procedure success rates in the three groups were 100%. The induction time in the 6 (3.3 +/- 1.0 min) and 8 mg/kg/h (2.9 +/- 0.6 min) ciprofol groups was longer than that in the propofol group (2.5 +/- 0.6 min) only in patients undergoing FB (p = 0.004). The time for patients to be fully alert and discharged from the post -anesthesia care unit was comparable across the three groups (p > 0.05). The incidence of drug-related AEs in the propofol and 6 and 8 mg/kg/h ciprofol groups was 84.1%, 76.8%, and 79.7%. No pain on injection was reported by ciprofol groups. Neurological outcomes and inflammatory responses were comparable among the three groups.