Ciprofol- a game changing intravenous anesthetic or another experimental drug!

Nair, Abhijit; Seelam, Suresh

doi:10.4103/sja.sja_898_21

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…Consistent with the results of previous research, pain on injection in the ciprofol-remifentanil group was low compared with pain reported by patients in the propofol-remifentanil group (6.52% vs. 36.96%) ( Ding et al, 2022 ); one reason for this difference is the lower concentration of drug in the aqueous phase of the emulsion. The greater hydrophobicity and lower plasma concentration of ciprofol may also contribute to the lower rates of injection pain versus propofol ( Nair and Seelam, 2022 ). Satisfaction of both patients and endoscopist and patients’ willingness to repeat FB were higher in the ciprofol-remifentanil group than in the propofol-remifentanil group, which may also be due in part to the lower incidence of pain on injection.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of ciprofol-remifentanil versus propofol-remifentanil during fiberoptic bronchoscopy: A prospective, randomized, double-blind, non-inferiority trial

Zhu

Wang

et al. 2022

Front. Pharmacol.

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Objective: Ciprofol is a novel 2,6-disubstituted phenol derivative that has improved pharmacokinetic and pharmacodynamic properties compared with propofol. This study was conducted to compare the efficacy and safety of ciprofol-remifentanil versus propofol-remifentanil for patients undergoing fiberoptic bronchoscopy.Methods: Overall, 92 patients undergoing fiberoptic bronchoscopy were included in this prospective, randomized, double-blind, non-inferiority trial and were equally divided into two groups (n = 46 each). Fentanyl (50 μg) was given 2 min before the intravenous infusion of 0.3 mg/kg of ciprofol or 1.2 mg/kg of propofol over a time period of 30 s. During anesthesia maintenance, 0.05–0.2 μg/kg/min of remifentanil combined with one-third to one-fourth of the initial dose of ciprofol or propofol was repeated at 2-min intervals, as required, to maintain a Modified Observer’s Assessment of Alertness and Sedation (MOAA/S) scale score <3. The primary outcome was the successful rate of fiberoptic bronchoscopy. Secondary outcomes included demographic characteristics, time metrics, hemodynamics, coughing severity, intubating conditions, lowest oxygen saturation, utilization of study drug doses, number of remedies (lidocaine and vasoactive drugs) used, satisfaction scores of both patients and the endoscopist, occurrence of intraoperative awareness, patients’ willing to repeat fiberoptic bronchoscopy, and occurrence and severity of adverse events.Results: The successful completion rate of fiberoptic bronchoscopy was 91.30% (42 of 46; 95% confidence interval [CI]: 82.80%–99.80%) in the ciprofol-remifentanil group and 89.13% (41 of 46; 95% CI: 79.80%–98.50%) in the propofol-remifentanil group. Though the clinically acceptable intubating condition was improved in the ciprofol-remifentanil group, this difference has no clinical statistical difference (p > 0.05). No significant differences were noted between the two groups with respect to time metrics, consumption of fentanyl and remifentanil, or number of remedies (lidocaine and vasoactive drugs). Patients’ willingness to repeat fiberoptic bronchoscopy and the satisfaction of both patients and endoscopist were significantly higher in the ciprofol-remifentanil than in the propofol-remifentanil group (p < 0.05). Compared with patients in the propofol-remifentanil group, patients in the ciprofol-remifentanil group had more stable hemodynamics. The lowest oxygen saturation was significantly higher in the ciprofol-remifentanil than in the propofol-remifentanil group (p < 0.05). The numbers of patients who experienced pain on injection in the ciprofol-remifentanil group was significantly lower than the number in the propofol-remifentanil group (p < 0.01). Severity of coughing, clinically acceptable severity of coughing, incidence of intraoperative awareness, and other adverse events were all similar between the two groups (p > 0.05). Only four patients experienced grade 2 adverse events (severe hypotension in one patient in the ciprofol-remifentanil group and three patients in the propofol-remifentanil group; p > 0.05); they were treated with noradrenaline.Conclusion: Ciprofol-remifentanil was non-inferior to propofol-remifentanil with regard to successful sedation for flexible bronchoscopy, when used with pre-intravenous administration of 50 μg of fentanyl. At the same time, patients’ willingness to repeat flexible bronchoscopy and the satisfactions were all significantly improved.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of ciprofol-remifentanil versus propofol-remifentanil during fiberoptic bronchoscopy: A prospective, randomized, double-blind, non-inferiority trial

Zhu

Wang

et al. 2022

Front. Pharmacol.

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“…This is the first case report of ciprofol administration for anesthesia in cardiac surgery with CPB. Ciprofol is a GABA receptor agonist and is a novel 2,6-disubstituted phenol derivative, like propofol[ 5 ]. Furthermore, the metabolites of ciprofol are nonhypnotic and nontoxic[ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Anesthesia with ciprofol in cardiac surgery with cardiopulmonary bypass: A case report

Liu¹,

Biskup²,

Lu³

2023

World J Clin Cases

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BACKGROUND Ciprofol is a novel agent for intravenous general anesthesia. In February 2022, it was approved by the National Medical Products Administration for general anesthesia induction and maintenance. It has the advantages of fast onset, fast elimination, stable circulation, and few adverse reactions. However, the efficacy and safety of ciprofol in cardiac surgery with cardiopulmonary bypass have not been reported. Here we describe a case where ciprofol was successfully used for anesthesia in cardiac surgery with cardiopulmonary bypass. CASE SUMMARY A 72-year-old man (height 176 cm; weight 70 kg) was diagnosed with coronary atherosclerotic cardiomyopathy requiring coronary artery bypass grafting and left ventricular aneurysmectomy. Ciprofol was administered for induction (0.4 mg/kg) and maintenance (0.6-1.0 mg/kg/h) of general anesthesia. During the entire operation, the bispectral index, hemodynamics, and blood oxygen saturation were maintained at normal levels. The patient recovered well after surgery, with no serious adverse events related to ciprofol. CONCLUSION Ciprofol is safe and effective for anesthesia in cardiac surgery with cardiopulmonary bypass.

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“…Ciprofol has been linked to dose-dependent respiratory depression, particularly in pediatric and elderly patients, as well as individuals with cardiovascular diseases and hypovolemia [ 15 ]. While specific studies have indicated favorable attributes of ciprofol, such as reduced injection pain and respiratory depression, compared to propofol, further comparative research is imperative to determine its superiority or equivalency to propofol across diverse clinical scenarios [ 15 ]. An extensive examination of ciprofol’s pharmacokinetics, encompassing parameters like plasma concentration and elimination half-life, has been undertaken.…”

Section: Reviewmentioning

confidence: 99%

Exploring Ciprofol Alternatives: A Comprehensive Review of Intravenous Anesthesia Options

Durai Samy,

Taksande

2024

Cureus

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Ciprofol is a recently developed, short-acting γ-aminobutyric acid receptor agonist sedative that is more potent than propofol. Still, there have been few clinical studies of this agent to date. This review explores alternative intravenous anesthesia options to ciprofol, considering their pharmacology, clinical efficacy, safety profile, and practical considerations. While ciprofol offers advantages such as rapid onset and predictable offset, concerns regarding its safety profile and individual variability in response have prompted the search for alternatives. Propofol, etomidate, ketamine, and dexmedetomidine are discussed as established options, each with unique characteristics and potential benefits. Emerging agents, including remimazolam, sufentanil, alfaxalone, and brexanolone, are examined for their potential role in anesthesia management. Recommendations for future research include large-scale comparative studies, optimization of dosing strategies, and personalized approaches guided by pharmacogenomic insights. Ultimately, the future of intravenous anesthesia lies in a multifaceted approach that integrates evidence-based practices, technological innovations, and individualized patient care to enhance safety, efficacy, and patient satisfaction across the perioperative continuum. Collaboration among stakeholders will be crucial in advancing the field and shaping the future landscape of intravenous anesthesia options.

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Ciprofol- a game changing intravenous anesthetic or another experimental drug!

Cited by 7 publications

References 5 publications

Efficacy and safety of ciprofol-remifentanil versus propofol-remifentanil during fiberoptic bronchoscopy: A prospective, randomized, double-blind, non-inferiority trial

Efficacy and safety of ciprofol-remifentanil versus propofol-remifentanil during fiberoptic bronchoscopy: A prospective, randomized, double-blind, non-inferiority trial

Anesthesia with ciprofol in cardiac surgery with cardiopulmonary bypass: A case report

Exploring Ciprofol Alternatives: A Comprehensive Review of Intravenous Anesthesia Options

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