The novel ciprofol versus propofol during gastroenteroscopy in Chinese patients: a meta-analysis

Gastrointestinal endoscopic interventions have become a routine practice in healthcare institutions. Propofol has been the most preferred general anesthetic agent for gastrointestinal endoscopic interventions. Ciprofol is a novel compound that has been approved by the China Medical Products Administration for sedation during gastrointestinal endoscopic procedures since December 2020. In this analysis, we aimed to systematically compare ciprofol versus propofol during gastroenteroscopy in Chinese patients.

The search databases included MEDLINE, EMBASE, Google scholar, Web of Science, http://www.Clinicaltrials.gov, and the Cochrane database. Studies which were based on Chinese participants were included in this analysis. The procedural outcomes and adverse drug events were considered as the endpoints. Statistical analysis was carried out by the RevMan software version 5.4. Risk ratios (RR) with 95% confidence intervals (CI) were used to represent results for dichotomous data whereas weighted mean differences (WMD) with 95% CI were used to represent the result for continuous data.

Twelve studies with a total number of 2055 Chinese participants (enrolled from 2017 to 2023) were included in this analysis whereby 1073 participants were assigned to ciprofol and 982 participants were assigned to propofol. Following the administration of anesthetic agent, the results for the induction time [WMD: 0.33; (95% CI: -0.64 to 1.30); P = 0.50], awake time [WMD: 0.42, (95% CI: 0.03-0.81); P = 0.03], duration of gastroenteroscopy [WMD: 0.22; (95% CI: -0.09 to 0.53); P = 0.16] and recovery time [WMD: 0.48; (95% CI: 0.13-0.83); P = 0.007] were not significantly worse with ciprofol compared to propofol. In addition, ciprofol was associated with a significantly lower risk of injection pain (RR: 0.15, 95% CI: 0.08-0.27; P = 0.00001), respiratory depression (RR: 0.49, 95% CI: 0.36-0.74; P = 0.0003), hypotension (RR: 0.76, 95% CI: 0.64-0.90; P = 0.001) and drowsiness (RR: 0.75, 95% CI: 0.57-0.98; P = 0.04). The risk for nausea and vomiting (RR: 0.95, 95% CI: 0.50-1.80; P = 0.87), bradycardia (RR: 1.03, 95% CI: 0.60-1.76; P = 0.92) and dizziness (RR: 0.93, 95% CI: 0.63-1.36; P = 0.70) were also not increased with ciprofol when compared to propofol in these Chinese patients.

Through this meta-analysis, it could be concluded that ciprofol was apparently not associated with significantly worse procedural outcomes nor associated with increased adverse drug events compared to propofol during gastroenteroscopy in Chinese patients. However, in view of several limitations in this analysis, this hypothesis should further be confirmed in future studies.