The trend of painless diagnostic and therapeutic procedures is on the increase among older patients as the global population is aging. The pathophysiological changes unique to the aging process are troublesome in terms of sedation management. The use of the traditional narcotic sedation guidelines like fentanyl and propofol is linked to respiratory and circulatory suppression in this at-risk group. Conversely, the new compound of alfentanil-ciprofol has shown potential pharmacological benefits that can maximize sedation in painless gastroscopy in the elderly. This is a systematic literature review discussing the physiological and pharmacological basis for sedation in older individuals, with a focus on the interactions and efficacy of alfentanil and ciprofol. By synthesizing the available evidence, we generalize upon the effectiveness, safety, quality of recovery and benefits of such a combination on the geriatric gastroscopy procedure. Furthermore, we address the challenges inherent to its use in this age group, such as dose individualization and respiratory management, and propose potential solutions. Lastly, we outline future research directions, emphasizing that individualized dosing strategies based on the principles of precision anesthesia will be central to optimizing outcomes for elderly patients.
Xiaoyun Zhang (Thu,) studied this question.