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Ciprofol reduces respiratory depression and hypoxemia compared to propofol during gastrointestinal endoscopyCiprofol shows fewer safety issues than propofol during endoscopy

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Key Takeaway
Note that ciprofol reduces respiratory depression and hypoxemia but may result in longer recovery times than propofol.

This meta-analysis evaluates the comparative efficacy and safety of ciprofol versus propofol in 2,084 adults undergoing gastrointestinal endoscopy. The study synthesizes data on several clinical outcomes, including induction time, recovery, and various adverse events.

Ciprofol was associated with significantly longer recovery times (WMD 0.83 min; 95% CI 0.16 to 1.49; P = 0.01). However, ciprofol demonstrated a lower risk of respiratory depression (RR 0.47; 95% CI 0.27 to 0.83), hypoxemia (RR 0.64; 95% CI 0.42 to 0.96), and hypotension (RR 0.81; 95% CI 0.72 to 0.90). Additionally, injection pain was less frequent with ciprofol (RR 0.13; 95% CI 0.08 to 0.22). Induction time and patient/physician satisfaction did not differ significantly between the two agents.

Several limitations affect the certainty of these findings, including the fact that all trials were conducted in China, high heterogeneity among pooled outcomes, and varying outcome definitions. Potential publication bias may also impact the results. Clinical application is currently limited as the findings are hypothesis-generating and require confirmation in larger, international trials.

How this fits prior evidence

This meta-analysis addresses a gap in comparing ciprofol to propofol for gastrointestinal endoscopy. While remimazolam was previously noted as a safer alternative to midazolam and propofol due to lower complication rates, this study provides specific data on ciprofol's profile regarding respiratory depression and hypoxemia. The finding of lower hypotension with ciprofol (RR 0.81) provides a specific comparison point for agents used in endoscopy.

When patients undergo a gastrointestinal endoscopy, they need to stay calm and comfortable. Doctors often use propofol to keep patients relaxed, but they are looking for ways to make the procedure even safer. A review of data from over 2,000 adults suggests that an alternative called ciprofol might offer some specific safety advantages.

The data shows that patients who received ciprofol had fewer instances of low blood pressure, less pain during the needle injection, and fewer cases of respiratory depression or low oxygen levels. While both drugs were effective at getting patients ready for the procedure, ciprofol patients took slightly longer to recover, by less than one minute on average. Patient and doctor satisfaction levels were similar for both medications.

It is important to note that these findings come from studies conducted only in China, and the results are considered preliminary. Because the study groups were very different and the definitions of success varied, these results are currently used to help form new ideas for research. More large, international studies are needed to confirm if these safety benefits hold true for everyone.

What this means for you:
Ciprofol may reduce risks like low blood pressure and breathing issues during endoscopy compared to propofol.

Common questions

Is ciprofol safer than propofol for endoscopy?

The data suggests ciprofol had fewer reported cases of low blood pressure, injection pain, and respiratory depression compared to propofol. However, because the study was limited to trials in China and had a lot of variation in how results were measured, these findings are currently used to guide future research rather than provide a definitive answer.

How long does it take to recover after using ciprofol?

Patients who received ciprofol had a recovery time that was statistically longer than those who received propofol, but the difference was very small, lasting less than one minute on average. Other factors, like how quickly the patient fell asleep, did not differ between the two drugs.

What are the risks of using these medications?

Both medications are used to keep patients comfortable during procedures. The study tracked risks like hypotension (low blood pressure), injection pain, respiratory depression, and hypoxemia (low oxygen). While ciprofol showed fewer instances of these issues than propofol, more international trials are needed to confirm these results.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
BackgroundWe compared ciprofol with propofol for painless gastrointestinal endoscopy, focusing on dose, recovery, induction, satisfaction, and adverse events.MethodsPubMed and Embase were searched through May 2026 for randomized controlled trials in adults undergoing painless gastrointestinal endoscopy. We pooled weighted mean differences (WMDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes using random-effects models. Risk of bias was assessed with the Cochrane tool. The protocol was prospectively registered in PROSPERO (CRD420251088249).ResultsEleven trials (2,084 participants) met the criteria. Recovery was statistically longer with ciprofol (WMD 0.83 min, 95% CI 0.16 to 1.49; P = 0.01), but the absolute difference was under 1 min; the difference was observed at 0.4 and 0.5 mg/kg. Induction time and physician and patient satisfaction did not differ significantly. Ciprofol was associated with fewer reported episodes of hypotension (RR 0.81, 95% CI 0.72–0.90), injection pain (RR 0.13, 95% CI 0.08–0.22), respiratory depression (RR 0.47, 95% CI 0.27–0.83), and hypoxemia (RR 0.64, 95% CI 0.42–0.96).ConclusionCiprofol and propofol produced broadly comparable procedural outcomes. The apparent advantages for selected adverse events and the dose-related recovery pattern are uncertain because all trials were conducted in China, several pooled outcomes were highly heterogeneous, outcome definitions varied, and publication bias was possible. The dose-stratified findings are exploratory, and the results are hypothesis-generating and require confirmation in larger international trials.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251088249, identifier PROSPERO CRD420251088249.
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