Ciprofol

Fiberoptic bronchoscopy (FB) procedures have become increasingly lengthy and complex. Maintaining deep sedation while preventing hypoxemia with conventional oropharyngeal/nasopharyngeal airways presents a significant clinical challenge. Supraglottic airway devices, such as the laryngeal mask airway (LMA), may provide improved oxygenation and procedural efficiency during FB. However, despite the variety of LMA designs, no previous studies have definitively established the optimal type of LMA for FB procedures.

96 patients were randomized to either the i-gel LMA group (group I) or Jiancheng dual-channel LMA group (group J). Remimazolam besylate, ciprofol, and sufentanil were used for anesthesia induction and maintenance in both groups. We measured and recorded the success rate of LMA insertion and entering the main airway through the LMA at first attempt, operational interference, mid-procedure LMA adjustments, procedure interruptions, vital signs, and major adverse events.

The patients in group J experienced higher success rates of first-attempt LMA insertion (P < 0.01) and entry into the main airway (P < 0.01) than those in group I. The incidence of coughing was significantly higher in group I than in group J (P < 0.01). The incidence of cardiopulmonary adverse reactions, including respiratory arrest, airway obstruction, airway spasm, laryngospasm, hypertension, and hypotension, was comparable between the two groups. Group I demonstrated a tendency toward prolonged recovery time compared with group J (P = 0.05).

The Jiancheng dual-channel LMA is associated with higher first-attempt success for airway insertion and bronchoscopy compared to the i-gel LMA, warranting consideration for broader clinical application.

https://www.chictr.org.cn/showproj.html?proj=265357 (registration no. ChiCTR2500100990, principal investigator: Ru-Ping Dai, date of registration: April 17, 2025).

To compare the incidence of hypoxia and other sedation‐related adverse events (AEs) in overweight patients undergoing gastrointestinal (GI) endoscopy who were sedated using ciprofol or propofol.

A randomized, controlled trial was conducted in five hospitals in China between September 2022 and August 2023. Patients were randomized into either ciprofol or propofol sedation. The primary outcome was the total incidence of hypoxia and severe hypoxia. The secondary outcomes were hypoxia incidence, severe hypoxia incidence, subclinical respiratory depression incidence, endoscopy success rate, injection pain incidence, and corrective hypoxic measures proportion.

A total of 1018 patients were randomized into either ciprofol group ( n  = 506) or propofol group ( n  = 512). The mean BMI was 26.23 kg/m 2 in the ciprofol group and 26.17 kg/m 2 in the propofol group. Compared with propofol, ciprofol showed lower incidences of total hypoxia and severe hypoxia in both the full analysis set (FAS) and per‐protocol analysis set (PPS). The lower incidence was particularly significant for severe hypoxia (4.35% vs. 7.62%, p  = 0.028 in FAS). The injection pain incidence was significantly lower in the ciprofol group than in the propofol group (2.57% vs. 13.28%, p  < 0.001 in FAS). Moreover, fewer patients in the ciprofol group required oxygen‐correction therapy (20.40% vs. 25.70%, p  = 0.047 in PPS), and ciprofol had a lower incidence of AEs associated with sedation.

During GI endoscopy, overweight patients are significantly less prone to hypoxia when sedated with ciprofol than with propofol, offering a safer alternative.

ClinicalTrials.gov (NCT05518929)