Ciprofol-Esketamine Versus Ciprofol-Remifentanil in Hysteroscopic Endometrial Polypectomy: A Randomized Controlled Trial

Background:Although ciprofol is a novel intravenous anesthetic known for its respiratory and hemodynamic stability, its use in hysteroscopic endometrial polypectomy (HEP) has rarely been reported.Therefore, this study investigated the therapeutic potential of a novel combination of ciprofol and esketamine to reduce complications and enhance recovery after HEP. Material/Methods:This prospective study enrolled 120 patients with endometrial polyps who underwent HEP.Participants were randomly assigned to receive either ciprofol plus esketamine (group CK, n=60) or ciprofol plus remifentanil (group CR, n=60).Two minutes after an initial bolus of esketamine (0.25 mg/kg) or remifentanil (1 g/kg), all patients received a standardized ciprofol bolus (0.4 mg/kg).The primary endpoint was transient hypoxemia.Secondary outcomes were hemodynamic parameters, recovery time, ciprofol consumption, adverse events, gynecologist satisfaction, and postoperative Visual Analog Scale (VAS) scores. Results:Compared with CR, CK significantly reduced hypoxemia (1.7% vs 35.0%;P<0.001) and hypotension (16.7% vs 33.3%; P=0.035).Post-induction systolic blood pressure was lower in group CR (P=0.047), but other hemodynamic parameters were similar between groups.CK provided superior early analgesia (VAS at 10 min: 2.20.7 vs 2.90.9;P<0.001).Other outcomes were comparable (P>0.05). Conclusions:The CK combination confers a clinical advantage over the CR combination for HEP.By mitigating the risk of hypoxemia and providing more effective short-term postoperative analgesia, the CK protocol represents a promising and potentially safer sedation regimen.