Hypoxemia occurs in people living with obesity undergoing gastroscopy under intravenous anesthesia. Preventing hypoxia in people living with obesity with appropriate anesthetics is therefore important. This study aims to compare the safety and efficacy of ciprofol versus propofol, both combined with sufentanil, for sedation during gastroscopy in people living with obesity. This prospective, randomized, controlled trial was conducted at the Endoscopic Center of Hangzhou Red Cross Hospital. Between August 2023 and August 2024, 652 patients were assessed for eligibility. Subsequently, Patients aged 18-65 years, classified as American Society of Anesthesiologists II, with a body mass index (BMI) between 30 and 40 kg/m², were enrolled. Participants were randomly assigned to receive either ciprofol or propofol, both combined with sufentanil, during their gastroscopy. The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2300074217). The primary outcome, hypoxemia, occurred in 34.3% of propofol patients vs 19.1% with ciprofol (absolute difference 15.2%; 95% CI 4.9--29.9%). For secondary outcomes, the propofol group experienced significantly more apnea episodes (17.9% vs 5.9%; absolute difference 12%; 95% CI 1.3% to 22.8%) and lower minimum SpO₂ values (90 80 to 95 vs 93 90 to 97; absolute difference --3; 95% CI --8 to 1). Endoscopist satisfaction was higher with ciprofol (4 3 to 5 vs 5 4 to 5; absolute difference --1; 95% CI --1 to 0), and injection pain was significantly more frequent in the propofol group (26.9% vs 1.5%; absolute difference 25.4%; 95% CI 14.4% to 36.4%). Ciprofol combined with sufentanil for gastroscopy sedation in people living with obesity, results in lower incidences of hypoxemia and injection pain, shorter apnea duration, and higher endoscopist satisfaction compared to propofol. Chinese Clinical Trial Registry: ChiCTR2300074217; 2023/08/01. People living with obesity can have difficulties breathing during stomach examinations when they are sedated, such as during gastroscopy. This puts them at risk of having low oxygen levels. We compared two drugs used to sedate people, ciprofol and the commonly used propofol, to see which one is safer for people with obesity undergoing gastroscopy. All patients received a pain-reliever (sufentanil), plus either ciprofol or propofol for sedation. We then monitored their breathing, oxygen levels, and any side effects. Patients receiving ciprofol had significantly fewer episodes of low oxygen levels and stopped breathing less often. They also experienced much less pain when the drug was injected and had more stable blood pressure. Doctors were more satisfied with the sedation quality in the ciprofol group. Ciprofol appears to be a safer and more comfortable option than propofol for sedating patients with obesity during gastroscopy. This could lead to fewer breathing problems and a better overall experience for at-risk patients. Zhao, Zhou et al. compare the safety of ciprofol versus propofol for sedation during gastroscopy in people with obesity. Ciprofol demonstrates a lower incidence of hypoxemia, reduced injection pain, and greater hemodynamic stability compared to propofol.
Zhao et al. (Thu,) studied this question.