Ciprofol versus propofol for adult sedation in gastrointestinal endoscopic procedures: a systematic review and meta-analysis
Guilherme Henrique Pires Carvalho Ortegal, Eduardo Cerchi Barbosa, Pedro Carvalho Campos Faria, JOÃO VÍTOR TEIXEIRA COUTO, Guilherme C. Silva, Márcio Henrique Ferreira de Souza, Lucas N. Ferreira, Vitor Ryuiti Yamamoto Moraes, Maria Clara Azzi Vaz de Campos, Luiza Azzi Vaz de Campos
Abstract
INTRODUCTION: Although propofol is widely preferred as a sedative agent in gastrointestinal endoscopy, its use is commonly associated with hemodynamic adverse events. New sedatives, such as ciprofol, are emerging with promising results. Thus, we aimed to perform a systematic review and meta-analysis to compare efficacy-, safety-, and satisfaction-related outcomes between ciprofol and propofol for adult sedation in gastrointestinal endoscopy. EVIDENCE ACQUISITION: We systematically searched MEDLINE, Embase, and Cochrane databases for randomized controlled trials comparing sedation with ciprofol vs. propofol in adult patients undergoing gastrointestinal endoscopy. Risk ratios (RRs) and mean differences (MDs) with their 95% confidence intervals (95% CIs) were employed for dichotomous and continuous outcomes, respectively, using a random-effects model. We conducted all statistical analyses using R software (version 4.2.1). EVIDENCE SYNTHESIS: We included six trials (1225 patients). The ciprofol group had a significantly lower risk of respiratory depression (RR 0.47; 95% CI 0.31, 0.71) and injection pain (RR 0.09; 95% CI 0.04, 0.20) compared with the propofol group, while there were no significant differences in other adverse events between both drugs. There were no significant differences between both groups in time-related outcomes, as well as in the probability of procedure success (RR 1.01; 95% CI 0.99, 1.03). Additionally, ciprofol provided a significantly higher patient satisfaction compared with propofol (MD 0.19; 95% CI 0.08, 0.31). CONCLUSIONS: This systematic review and meta-analysis demonstrated similar clinical efficacy and better safety profile of ciprofol compared with propofol for adult sedation in gastrointestinal endoscopies. Furthermore, patient satisfaction scores were higher with ciprofol.