Ciprofol less painful and safer than propofol for induction of GA and sedation: Study

Propofol has been utilized in the medical field as an anesthetic agent for inducing and maintaining general anesthesia due to its benefits. Nevertheless, it is associated with limitations such as pain upon injection. A new anaesthetic drug called ciprofol has recently garnered attention as a potential solution to address several drawbacks linked to propofol. Recent systematic review and meta-analysis evaluated the anesthetic and sedative efficacy and safety of ciprofol compared to propofol in adult patients undergoing various procedures. The analysis included 19 randomized controlled trials with a total of 2,841 participants. The key findings are as follows:

Efficacy

Efficacy: There was no significant difference between ciprofol and propofol in the success rate of endoscopy procedures. However, ciprofol showed a small but statistically significant increase in the success rate of general anesthesia/sedation induction compared to propofol. There were also no differences between the two drugs in induction time, time to eyelash reflex disappearance, insertion time, or discharge time. Ciprofol did show a significantly longer awakening time compared to propofol.

Safety

Safety: Ciprofol demonstrated significantly less pain on injection compared to propofol. Ciprofol also had a significantly lower incidence of adverse events overall compared to propofol, though there was no difference in the rate of serious adverse events between the two drugs.

Patient and Provider Satisfaction

Patient and provider satisfaction: Ciprofol showed significantly higher patient satisfaction compared to propofol, though there was no difference in anesthesiologist satisfaction between the two drugs.

Vital Signs

Vital signs: Ciprofol was associated with a significant increase in systolic and diastolic blood pressure compared to propofol, though there were no differences in other vital signs like heart rate, mean arterial pressure, and oxygen saturation.

Conclusion

In summary, this comprehensive meta-analysis found that ciprofol exhibited comparable efficacy to propofol in inducing general anesthesia and sedation, with some advantages in terms of reduced injection pain, fewer adverse events, and higher patient satisfaction. These findings suggest that ciprofol may be a viable alternative to propofol for anesthesia and sedation in various clinical settings. However, the authors note the need for further research, particularly studies conducted outside of China, to confirm these results and establish broader clinical guidelines for the use of ciprofol.

Key Points

1. Efficacy: There was no significant difference between ciprofol and propofol in the success rate of endoscopy procedures, but ciprofol showed a small but statistically significant increase in the success rate of general anesthesia/sedation induction compared to propofol. There were also no differences between the two drugs in induction time, time to eyelash reflex disappearance, insertion time, or discharge time, though ciprofol did show a significantly longer awakening time.

2. Safety: Ciprofol demonstrated significantly less pain on injection compared to propofol and had a significantly lower incidence of adverse events overall, though there was no difference in the rate of serious adverse events between the two drugs.

3. Patient and Provider Satisfaction: Ciprofol showed significantly higher patient satisfaction compared to propofol, though there was no difference in anesthesiologist satisfaction between the two drugs.

4. Vital Signs: Ciprofol was associated with a significant increase in systolic and diastolic blood pressure compared to propofol, though there were no differences in other vital signs like heart rate, mean arterial pressure, and oxygen saturation.

5. The comprehensive meta-analysis found that ciprofol exhibited comparable efficacy to propofol in inducing general anesthesia and sedation, with some advantages in terms of reduced injection pain, fewer adverse events, and higher patient satisfaction.

6. The authors note the need for further research, particularly studies conducted outside of China, to confirm these results and establish broader clinical guidelines for the use of ciprofol.

Reference -

Saeed A, Elewidi M, Nawlo A, Elzahaby A, Khaled A, Othman A, et al. Efficacy and safety of ciprofol versus propofol for induction of general anaesthesia or sedation: A systematic review and meta‑analysis of randomised controlled trials. Indian J Anaesth 2024;68:776‑94