Clinical effect of different doses of ciprofol for induction of general anesthesia in elderly patients: A randomized, controlled trial

Duan, Gongchen; Lan, Haiyan; Shan, Weifeng; Wu, Yanzhi; Xu, Qiwu; Dong, Xiaoli; Mei, Peiyi; You, Minji; Jin, Linfei; Wu, Jimin

doi:10.1002/prp2.1066

Cited by 11 publications

(9 citation statements)

References 22 publications

(35 reference statements)

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“…This study also found a signi cant difference in the ED50 of ciprofol for TB patients of different genders and ages, and the ED50 of ciprofol in elderly patients were signi cantly lower than the non-elderly patients, and ED50 of ciprofol in the female patients were signi cantly lower than the male patients, suggesting that there may be age and gender differences in the pharmacokinetics and pharmacodynamics of ciprofol, which was consistent with Li et al's conclusion that the use of 0.3 mg/kg of ciprofol in elderly people was equally effective as the use of 0.4 mg/kg in non-elderly people [10]. It was also consistent with the conclusion reported by Duan et al that the recommended use of low-dose (0.3 mg/kg) ciprofol for anesthesia induction in elderly patients had better safety and effectiveness [11], which may be related to weakened liver and kidney functions and cardiovascular system decline in the elderly [15,25]. Elderly patients have a decrease in myocardial contractility, coronary blood ow, and ventricular compliance, making it di cult for them to tolerate excessive volume loading [26].…”

Section: Discussionsupporting

confidence: 90%

“…The age of the non-elderly group was de ned as 18-64 years old, while the age of the elderly group was de ned as ≥ 65 years old [10,11]. The exclusion criteria were as follows: patients with recent major hemoptysis, severe stenosis of the main airway, myasthenia gravis, severe cardiovascular disease, longterm history of taking psychotropic drugs, allergies to anesthetic drugs and their components, and estimated surgical duration exceeding 30 minutes.…”

Section: Patients and Clinical Protocolmentioning

confidence: 99%

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ED50 of Ciprofol Combined with Sufentanil for Fiber Bronchoscopy of Different Patient Populations with Pulmonary Tuberculosis

Pan

Liu

Zhang

et al. 2023

Preprint

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Backgroud: Ciprofol is a promising sedative. At present, there were few clinical studies on the median effective dose (ED50) of ciprofol. The aim of this study was to compare the ED50 of ciprofol for fiberoptic bronchoscopy in pulmonary tuberculosis (TB) patients of different genders and ages. Methods：TB patients who underwent bronchoscopy examination and treatment at The Third People’s Hospital of Changzhou between May 2023 and June 2023 were selected, and divided into four groups according to stratified random method: Group N1 (non-elderly male patients), Group N2 (non-elderly female patients), Group N3 (elderly male patients), and Group N4 (elderly female patients). All patients received intravenous injection of 0.15 μg/kg sufentanil followed by injection of the test dose of ciprofol according to Dixon’s modified sequential method. Fiberoptic bronchoscopy was performed after the disappearance of the eyelash reflex. The initial dose of ciprofol in all four groups of TB patients was 0.4 mg/kg, and the ratio of adjacent doses was 1:1.1. The next patient received a 10% increase in the dose of ciprofol if the patient in the same group experienced positive reactions such as choking cough, frowning, and body movements during the endoscopy process. Otherwise, it was judged as a negative reaction, and the next patient received a 10% decrease in the dose of ciprofol. The transition from a positive reaction to a negative reaction was defined as a turning point, and the study of the group was terminated when seven turning points occurred. Hemodynamic parameters, oxygen saturation and adverse reactions were recorded at different time points in all groups. The Probit regression analysis method was used to calculate the ED50 of ciprofol in the four groups and compare between the groups. Results: The ED50 of ciprofol combined with 0.15 μg/kg sufentanil for bronchoscopy in the four groups were 0.465 mg/kg, 0.433 mg/kg, 0.420 mg/kg and 0.396 mg/kg, respectively. The ED50 of ciprofol in the Group N1 was significantly higher compared with the Group N2 and Group N3 (p<0.05). The ED50 of ciprofol in the Group N4 was significantly lower compared with the Group N2 and Group N3 (p<0.05). Conclusions: The ED50 of ciprofol used for fiber bronchoscopy in patients with TB of different genders and ages was different. Trial registration: The Chinese Clinical Trial Registry, ChiCTR2300071508, Registered on 17 May 2023.

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Section: Discussionsupporting

confidence: 90%

Section: Patients and Clinical Protocolmentioning

confidence: 99%

ED50 of Ciprofol Combined with Sufentanil for Fiber Bronchoscopy of Different Patient Populations with Pulmonary Tuberculosis

Pan

Liu

Zhang

et al. 2023

Preprint

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“…This aligns with effective doses reported in earlier phase I-III studies and provides a more precise estimation. Our study reveals a slightly higher effective dose of ciprofol compared to the 0.3 mg/kg recommended by Wu 15 , Ding 16 , and Duan 17 . This variation may be due to the different stimulation intensities between beroptic bronchoscopy and tracheal intubation, and the use of topical anesthesia in Wu's study prior to bronchoscope insertion.…”

Section: Discussioncontrasting

confidence: 55%

Comparative effective dose of ciprofol and propofol in suppressing cardiovascular responses to tracheal intubation: a single-center, double-blind, randomized, controlled clinical trial

Liao,

Wu,

et al. 2024

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Ciprofol, a novel γ-aminobutyric acid receptor agonist, outperforms propofol with minimal cardiovascular effects, higher potency, reduced injection pain, and a broader safety margin. Despite these advantages, ciprofol's clinical research is still emerging. This study compares the median effective dose (ED50) and adverse reactions of ciprofol and propofol, in conjunction with sufentanil, for suppressing cardiovascular responses during tracheal intubation.A total of fifty-three adult patients who required general anesthesia for tracheal intubation were enrolled in this study. The patients were randomly assigned to either the ciprofol group (group C) or the propofol group (group P) using a random number table. Tracheal intubation was performed using a standardized laryngoscope and endotracheal tube. The Dixon's up-and-down method was employed to determine the ED50 and 95% effective dose (ED95) of ciprofol and propofol in inhibiting cardiovascular responses during tracheal intubation. Based on the pilot study, the initial dose of ciprofol was set at 0.35 mg/kg (with a dose increment of 0.01 mg/kg) and propofol was set at 2.0 mg/kg (with a dose increment of 0.1 mg/kg). Dose-response curves were generated using probit analysis to establish the ED50 and ED95 required to inhibit cardiovascular responses during tracheal intubation. Adverse events following drug administration were closely monitored.A total of 54 participants were included in the study, with 24 in group C (one participant excluded due to repeated intubation) and 30 in group P. Probit analysis revealed that the ED50 and ED95 of ciprofol for inhibiting cardiovascular responses to tracheal intubation were 0.326 mg/kg (95% CI 0.304-0.337 mg/kg) and 0.349 mg/kg (95% CI 0.337-0.470 mg/kg), and for propofol, 1.541 mg/kg (95% CI 1.481-1.599 mg/kg) and 1.656 mg/kg (95% CI 1.599-1.943 mg/kg). Notably, group C demonstrated more stable hemodynamics during induction and showed a significantly lower incidence of injection pain compared to group P. Ciprofol demonstrated more stable hemodynamics and a lower incidence of adverse events during induction. Ciprofol may potentially be used as a substitute for propofol in a wider range of scenarios. Clinical Trial Registration: hppts://ClinicalTrials.gov; Identifier: NCT06095570(23/10/2023).

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“…Though most studies affirm the safety of both drugs for clinical practice, it is worth noting that the existing literature on the comparison between these two drugs is relatively limited. Looking ahead, future research should delve into optimized ciprofol dosing strategies aimed at achieving the desired depth of anesthesia while minimizing side effects [ 33 ]. Exploring patient-centered outcomes and integrating advanced monitoring technologies could also provide deeper insights into the comparative strengths and weaknesses of these agents.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of ciprofol versus propofol for induction and maintenance of general anesthesia: a systematic review and meta-analysis

Hudaib,

Malik,

Zakir

et al. 2024

J Anesth Analg Crit Care

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Background Propofol has been the gold standard for anesthesia induction and maintenance due to its rapid onset and favorable pharmacokinetic properties. However, the search for alternative agents with improved safety and efficacy has led to the emergence of ciprofol (HSK3486), a structural analog of propofol. This systematic review and meta-analysis aim to comprehensively assess the safety and efficacy of ciprofol compared to propofol for anesthesia induction and maintenance in adult patients undergoing surgical procedures. Methods This study included only double-arm RCTs in which participants were aged eighteen or older undergoing surgery. For the statistical analysis of the extracted data, we employed RevMan 5.4.1. Results Ciprofol demonstrated a promising trend of higher anesthesiologists’ satisfaction during the induction phase (MD 0.14, 95%, CI − 0.28 to 0.56, p = 0.51), whereas Propofol was favored during maintenance. Propofol also exhibited advantages with a shorter time to successful anesthesia induction (MD 0.08 min, 95% CI 0.00 to 0.15, p = 0.04), and quicker attainment of full alertness (MD 0.11 min, 95% CI − 1.29 to 1.52, p = 0.87), suggesting its efficiency in clinical practice. Importantly, there were no significant disparities in the success rate of anesthesia. Conclusion Both ciprofol and propofol demonstrate comparable efficacy and safety for anesthesia induction and maintenance in adult patients undergoing surgery. While propofol provides a faster onset of induction, ciprofol exhibits advantages in terms of pain management. Clinicians should consider these findings when selecting anesthetic agents, and tailoring choices to individual patient needs and clinical scenarios.

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Clinical effect of different doses of ciprofol for induction of general anesthesia in elderly patients: A randomized, controlled trial

Cited by 11 publications

References 22 publications

ED50 of Ciprofol Combined with Sufentanil for Fiber Bronchoscopy of Different Patient Populations with Pulmonary Tuberculosis

ED50 of Ciprofol Combined with Sufentanil for Fiber Bronchoscopy of Different Patient Populations with Pulmonary Tuberculosis

Comparative effective dose of ciprofol and propofol in suppressing cardiovascular responses to tracheal intubation: a single-center, double-blind, randomized, controlled clinical trial

Efficacy and safety of ciprofol versus propofol for induction and maintenance of general anesthesia: a systematic review and meta-analysis

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