Ciprofol versus propofol for sedation in colonoscopy: a systematic review and meta-analysis of randomized controlled trials
Ciprofol versus propofol para sedação em colonoscopia: uma revisão sistemática e metanálise de ensaios clínicos randomizados
Saul Dominici, Italo C. Martins, Breno Dias L. Ribeiro, Victor Arthur Ohannesian, Brunno Braga Sauaia, Abdias Rocha Santos, Caio Márcio Barros de Oliveira, Plínio da Cunha Leal
Abstract
Background
Ciprofol has emerged as a potential alternative sedative with improved safety and efficacy. However, comparative data for colonoscopy sedation remain limited.
Methods
A systematic search in PubMed, Embase, Cochrane Library, and Web of Science identified RCTs published through August 2025. Studies included patients undergoing colonoscopy using ciprofol or propofol, reporting relevant efficacy or safety outcomes. Risk Ratios (RRs) and Mean Differences (MDs) were calculated using the Mantel-Haenszel random-effects model and 95% Confidence Intervals. The heterogeneity was assessed with I 2 statistics and Cochrane Q test. Primary outcomes were procedure success rate and patient satisfaction (assessed on a 1-to-10 scale). Secondary outcomes included sedation onset time(s), respiratory depression, injection pain, and hemodynamic adverse events (hypotension and bradycardia). The statistical analyses were performed in R software (version 4.4.1.)
Results
Three RCTs with 645 patients were included. Colonoscopy success rates were similar between ciprofol and propofol (RR = 1.005; 95% CI 0.992−1.019). Ciprofol showed a lower risk of respiratory depression (RR = 0.24; 95% CI 0.08−0.71), injection pain (RR = 0.04; 95% CI 0.01−0.15), and hypotension (RR = 0.85; 95% CI 0.75−0.96). Patient satisfaction was slightly higher with ciprofol (MD = 0.18; 95% CI 0.08−0.29). No significant differences were found in sedation onset time (s) (MD = 2.49s; 95% CI -3.77−8.74) or bradycardia (RR = 0.88; 95% CI 0.44−1.77).
Conclusion
Ciprofol provides comparable efficacy to propofol for colonoscopy sedation, with a lower incidence of respiratory depression, injection pain, and hypotension. Patient satisfaction was slightly higher with ciprofol, while bradycardia occurrence was similar. These findings suggest ciprofol as a promising alternative, though further large-scale studies are needed to confirm its clinical benefits.
Keywords
Resumo
Introdução
O ciprofol surgiu como um sedativo alternativo potencial, com melhor segurança e eficácia. No entanto, dados comparativos para sedação em colonoscopia ainda são limitados.
Métodos
Uma busca sistemática nas bases PubMed, Embase, Cochrane Library e Web of Science identificou RCTs publicados até agosto de 2025. Os estudos incluíram pacientes submetidos à colonoscopia usando ciprofol ou propofol, relatando desfechos relevantes de eficácia ou segurança. Foram calculados Razões de Risco (RRs) e Diferenças Médias (MDs) usando o modelo de efeitos aleatórios de Mantel-Haenszel e Intervalos de Confiança de 95%. A heterogeneidade foi avaliada com as estatísticas I² e o teste Q de Cochrane. Os desfechos primários foram taxa de sucesso do procedimento e satisfação do paciente (avaliada em escala de 1 a 10). Os desfechos secundários incluíram tempo(s) de início de sedação, depressão respiratória, dor à injeção e eventos adversos hemodinâmicos (hipotensão e bradicardia). As análises estatísticas foram realizadas no software R (versão 4.4.1).
Resultados
Três RCTs com 645 pacientes foram incluídos. As taxas de sucesso da colonoscopia foram semelhantes entre ciprofol e propofol (RR = 1,005; CI 95% 0,992–1,019). O ciprofol apresentou menor risco de depressão respiratória (RR = 0,24; CI 95% 0,08–0,71), dor à injeção (RR = 0,04; CI 95% 0,01–0,15) e hipotensão (RR = 0,85; CI 95% 0,75–0,96). A satisfação do paciente foi ligeiramente maior com ciprofol (MD = 0,18; CI 95% 0,08–0,29). Não houve diferenças significativas no tempo de início da sedação (s) (MD = 2,49s; CI 95% −3,77–8,74) ou na bradicardia (RR = 0,88; CI 95% 0,44–1,77).
Conclusion
O ciprofol apresenta eficácia comparável à do propofol para sedação em colonoscopia, com menor incidência de depressão respiratória, dor à injeção e hipotensão. A satisfação do paciente foi discretamente maior com ciprofol, enquanto a ocorrência de bradicardia foi semelhante. Esses achados sugerem o ciprofol como uma alternativa promissora, embora estudos adicionais de maior escala sejam necessários para confirmar seus benefícios clínicos.
Palavras-chave
References
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Submitted date:
06/23/2025
Accepted date:
11/07/2025
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