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REVIEW article

Front. Anesthesiol.
Sec. Perioperative Medicine
Volume 3 - 2024 | doi: 10.3389/fanes.2024.1496463

Efficacy and safety of ciprofol versus propofol for painless gastrointestinal endoscopes: A systematic review and meta-analysis of randomized controlled trials (RCT)

Provisionally accepted
Zhaoxuan Wang Zhaoxuan Wang 1Siru Wang Siru Wang 1*Lu Liu Lu Liu 2*Xiaolu Zhang Xiaolu Zhang 1Meijuan Ren Meijuan Ren 1*Qianqian Zhang Qianqian Zhang 1*Chang Liu Chang Liu 2*
  • 1 Ocean University of China, Qingdao, China
  • 2 Qingdao Women and Children's Hospital, Qingdao, Shandong Province, China

The final, formatted version of the article will be published soon.

    Background: Ciprofol is considered an alternative to propofol and can be used to achieve anesthesia at a lower dose with a lower incidence of adverse events. The primary objective of this study was to compare the efficacy and safety of ciprofol and propofol used in painless gastrointestinal endoscopes.Methods: The databases of PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure were retrieved for randomized controlled trials of ciprofol and propofol used in gastrointestinal endoscopes from inception to May 10, 2024. All statistical analyses were conducted using Stata 14.0. Primary outcomes encompassed a successful rate of sedation and other safety outcomes, including injection pain, hypotension, bradycardia, overall respiratory disorders, and hypoxemia. Secondary outcomes concluded time to onset of successful induction, waking time, and discharge time.Results: A total of 20 studies were included, involving 3779 patients. The results of the meta-analysis showed that the successful rate of anesthesia and waking time were not significantly different between ciprofol and propofol, while ciprofol was better than propofol in injection pain (RR: 0.10, 95% CI: 0.07 to 0.16, p < 0.001, I 2 = 46.4%, moderate certainty), hypotension (RR: 0.68, 95% CI: 0.59 to 0.77, p < 0.001, I 2 = 49.2%, moderate certainty), bradycardia (RR: 0.67, 95% CI: 0.52 to 0.85, p = 0.001, I 2 = 0.0%, moderate certainty), hypoxemia (RR: 0.45, 95% CI: 0.33 to 0.61, p < 0.001, I 2 = 9.2%, moderate certainty), and overall respiratory disorders (RR: 0.45, 95% CI: 0.27 to 0.75, p < 0.001, I 2 = 77.1%, moderate certainty). In addition, compared to propofol, shorter time to onset of successful induction (MD: -0.16, 95% CI: -0.24 to -0.08, p < 0.001, I 2 = 97.2%, very low certainty) and longer discharge time (MD: 0.420, 95% CI: 0.29 to 0.54, p < 0.001, I 2 = 29.4%, moderate certainty) were related to ciprofol. Conclusion: In summary, although the results indicated that ciprofol takes longer to recover after surgery, it greatly improved the pain problem and hemodynamic stability of intravenous propofol. Therefore, we believe that ciprofol can be used as an excellent substitute for propofol.

    Keywords: Ciprofol, Propofol, Anesthesia, efficacy, Safety, Meta-analysis

    Received: 14 Sep 2024; Accepted: 08 Nov 2024.

    Copyright: © 2024 Wang, Wang, Liu, Zhang, Ren, Zhang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Siru Wang, Ocean University of China, Qingdao, China
    Lu Liu, Qingdao Women and Children's Hospital, Qingdao, Shandong Province, China
    Meijuan Ren, Ocean University of China, Qingdao, China
    Qianqian Zhang, Ocean University of China, Qingdao, China
    Chang Liu, Qingdao Women and Children's Hospital, Qingdao, Shandong Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.