Yu Yunfeng, Deng Juan, Yin Yuman, Yang Xinyu, Liao Min, Yu Rong
School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China.
Department of Anesthesiology, People's Hospital of Ningxiang City, Changsha, China.
Int J Surg. 2025 Jul 17. doi: 10.1097/JS9.0000000000003064.
Ciprofol, a propofol derivative, is increasingly used for sedation in China. However, the specific benefits of ciprofol in gastrointestinal endoscopic sedation have not been fully evaluated. This meta-analysis aimed to compare the efficacy and safety of ciprofol with propofol in gastrointestinal endoscopy.
Four public databases were searched for the relevant literature to 1 February 2025. Studies were excluded based on predefined criteria, and the characteristics and outcome data of each included study were collected. Subsequently, meta-analysis and trial sequential analysis (TSA) were performed using Review Manager 5.3 and TSA 0.9.5.10 Beta, respectively.
Nine studies involving 1860 participants were included in this study. Compared with propofol, ciprofol significantly reduced rates of hypotension (risk ratio [RR] 0.75, 95% confidence interval [CI] 0.63-0.89), respiratory depression (RR 0.71, 95% CI 0.56-0.91), hypoxemia (RR 0.65, 95% CI 0.48-0.87), choking cough (RR 0.74, 95% CI 0.57-0.95), and injection pain (RR 0.11, 95% CI 0.06-0.22). Awakening time of ciprofol was slightly prolonged (mean difference [MD] 0.81 minutes, 95% CI 0.02-1.61), though not clinically significant. Bradycardia, involuntary movement, dizziness, nausea, and vomiting were comparable between the two groups (P > 0.05). Moreover, TSA demonstrated that the results of hypotension, hypoxemia, respiratory depression, and injection pain observed in the current sample size were decisive. Regression analysis did not reveal any potential publication bias.
Ciprofol offers notable advantages over propofol in gastrointestinal endoscopic sedation, including a lower incidence of injection pain, hypotension, respiratory depression, and hypoxemia. A dosage of 0.4 mg/kg of ciprofol may be an effective alternative to propofol, as it further reduces the risk of involuntary movements. However, caution is warranted, as ciprofol may increase the risk of dizziness during procedures lasting 10 minutes or longer.
环丙泊酚是一种丙泊酚衍生物，在中国越来越多地用于镇静。然而，环丙泊酚在胃肠内镜镇静中的具体益处尚未得到充分评估。本荟萃分析旨在比较环丙泊酚与丙泊酚在胃肠内镜检查中的疗效和安全性。
检索四个公共数据库至2025年2月1日的相关文献。根据预先设定的标准排除研究，并收集每项纳入研究的特征和结局数据。随后，分别使用Review Manager 5.3和TSA 0.9.5.10 Beta进行荟萃分析和试验序贯分析（TSA）。
本研究纳入了9项涉及1860名参与者的研究。与丙泊酚相比，环丙泊酚显著降低了低血压发生率（风险比[RR]0.75，95%置信区间[CI]0.63 - 0.89）、呼吸抑制发生率（RR 0.71，95% CI 0.56 - 0.91）、低氧血症发生率（RR 0.65，95% CI 0.48 - 0.87）、呛咳发生率（RR 0.74，95% CI 0.57 - 0.95）和注射痛发生率（RR 0.11，95% CI 0.06 - 0.22）。环丙泊酚的苏醒时间略有延长（平均差[MD]0.81分钟，95% CI 0.02 - 1.61），但无临床意义。两组之间的心动过缓、不自主运动、头晕、恶心和呕吐情况相当（P > 0.05）。此外，TSA表明在当前样本量下观察到的低血压、低氧血症、呼吸抑制和注射痛结果具有决定性。回归分析未发现任何潜在的发表偏倚。
在胃肠内镜镇静方面，环丙泊酚比丙泊酚具有显著优势，包括注射痛、低血压、呼吸抑制和低氧血症的发生率较低。0.4mg/kg的环丙泊酚剂量可能是丙泊酚的有效替代方案，因为它进一步降低了不自主运动的风险。然而，需要谨慎，因为环丙泊酚可能会增加持续10分钟或更长时间的操作过程中头晕的风险。
