Objective Explore the clinical efficacy and safety of ciprofol-etomidate (C-E) versus propofol-etomidate (P-E) for gastrointestinal endoscopy sedation, and generate hypotheses for subsequent prospective pre-registered trials. Methods A prospective, double-blind, randomized, positive-controlled exploratory trial enrolled 240 adults (120 per group). Exploratory outcomes included hemodynamics, adverse events, and Chalder Fatigue Questionnaire (CFQ) scores. Intention-to-treat (ITT) analysis was primary, with per-protocol analysis (PPA, n = 223) as sensitivity validation. Results C-E group showed significantly lower CFQ Bimodal scores ≥4, postoperative dizziness incidence, and blood pressure fluctuations (20% baseline; all p 0.05). One P-E patient needed respiratory support for SpO₂ = 85%. Other outcomes (e.g., induction time, total dose) were comparable. ITT and PPA results were consistent. Conclusion This retrospective registered exploratory study tentatively suggests C-E may offer potential advantages in hemodynamic stability, respiratory safety, and reduced post-procedural fatigue/dizziness for low-risk (ASA I ~ II) patients. Findings are hypothesis-generating and require validation via prospective pre-registered trials. Systematic review registration https://www.chictr.org.cn/indexEN.html , identifier ChiCTR2500107221.
Gu et al. (Fri,) studied this question.