Comparison of Ciprofol-Nalbuphine and Propofol-Nalbuphine Sedation During Painless Gastrointestinal Endoscopy: A Randomized Controlled Trial.

BACKGROUND Although propofol is widely used for painless gastrointestinal endoscopy, cardiopulmonary adverse events associated with its use are still common. Ciprofol is a novel intravenous anesthetic with respiratory and hemodynamic stability. The aim of this study was to evaluate the benefits of ciprofol combined with nalbuphine for painless gastrointestinal endoscopy in reducing the occurrence of cardiopulmonary adverse events and improving postendoscopic recovery. MATERIAL AND METHODS In this single-center randomized study, a total of 128 patients undergoing painless gastrointestinal endoscopy were randomly assigned to 2 groups: propofol combined with nalbuphine or ciprofol combined with nalbuphine. All patients received 0.15 mg/kg nalbuphine intravenously before the study drugs were administered. The propofol group received a bolus of 2 mg/kg propofol intravenously, whereas the ciprofol group received a bolus of 0.4 mg/kg ciprofol intravenously. The primary endpoint was the incidence of intraprocedural cardiopulmonary adverse events (hypotension, bradycardia, and hypoxemia). RESULTS The ciprofol group demonstrated a significantly lower rate of cardiopulmonary adverse events during induction, compared with the propofol cohort (4.8% vs 18.7%; P=0.028). Furthermore, ciprofol administration was associated with lower procedural complications, including injection pain, cough reflex, and body movement (P=0.011). CONCLUSIONS Ciprofol-nalbuphine sedation demonstrates a superior safety profile, with fewer hemodynamic and respiratory perturbations and improved procedural tolerance, compared with propofol-nalbuphine in painless gastrointestinal endoscopy, while maintaining equivalent sedative efficacy and enhanced recovery characteristics.