S700 Ciprofol vs Propofol for the Sedation/Anesthesia During Endoscopic Procedures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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Introduction: Ciprofol is a novel anesthetic agent that is originally a structural analog of propofol with much potency, improved pharmacological and physicochemical properties, and less pain in the injection sites. We aim to evaluate the comparative efficacy and safety of ciprofol vs propofol for sedation/anesthesia during endoscopic procedures. Methods: We conducted a systematic review and meta-analysis synthesizing randomized controlled trials (RCTs), which were retrieved by systematically searching: PubMed, Web of Science, SCOPUS, and Cochrane through May 8th, 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI). Results: We included four RCTs with a total of 686 patients. Ciprofol was significantly associated with increased patient satisfaction (MD: 0.18 with 95% CI [0.08, 0.29], P = 0.0007), and reduced pain on injection (RR: 0.09 with 95% CI [0.05, 0.16], P = 0.00001) (Figure 1: A&B). Also, ciprofol was comparable to propofol regarding endoscopy success rate (RR: 1.01 with 95% CI [0.99, 1.03], P = 0.35), induction time (MD: 0.54 with 95% CI [-0.18, 1.27], P = 0.14), insertion time (MD: 0.48 with 95% CI [-0.05, 1.01], P = 0.08), discharge time (MD: 0.97 with 95% CI [-0.36, 2.30], P = 0.15), the incidence of any adverse events (RR: 0.98 with 95% CI [0.90, 1.08], P = 0.74), and serious adverse events (RR: 0.45 with 95% CI [0.08, 2.45], P = 0.36) (Figure 1: C-H). However, ciprofol was associated with prolonged recovery time (MD: 1.56 with 95% CI [1.11, 2.02], P = 0.00001) (Figure 1: I). Conclusion: Ciprofol was associated with improved patient satisfaction and decreased injection pain, with comparable efficacy with propofol, except for recovery time. Therefore, it constitutes a promising strategy for sedation/anesthesia during endoscopic procedures, warranting further large-scale RCTs to define the most effective dosage and anastatic cocktail during different endoscopic procedures.Figure 1.: Forest plots for meta-analyses comparing Ciprofol vs Propofol in regards to A) Patient Satisfaction B) Pain on Injection C) Endoscopy Success Rate D) Induction Time E) Insertion Time F) Discharge Time G) Any Adverse Events H) Any Serious Adverse event I) Recovery Time.

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