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. 2025 May 1:19:3577-3587.
doi: 10.2147/DDDT.S494972. eCollection 2025.

The Median Effective Dose of Ciprofol Combined with Sufentanil for Inhibiting Responses to Gastroscope Insertion in Obese Patients: A Prospective, Single-Center Study

Zhouya Xue #  1   2 , Xiang Liu #  1   2 , Weisheng Qian  1 , Nan Yang  1 , Yongyi Pan  1 , Yong Zhou  1 , Wei Jiang  1 , Feng Li  1 , Bin Qian  1
Affiliations

The Median Effective Dose of Ciprofol Combined with Sufentanil for Inhibiting Responses to Gastroscope Insertion in Obese Patients: A Prospective, Single-Center Study

Zhouya Xue et al. Drug Des Devel Ther. .

Abstract

Background: Ciprofol, a recently developed intravenous anesthetic, whereas sufentanil is a widely used adjuvant for gastroenteroscopy sedation. The recommended dosage of ciprofol for obese patients remains unclear. Our study aimed to determine the median effective dose (ED50) of ciprofol in combination with sufentanil for obese patients undergoing gastroscopy sedation.

Methods: A total of 70 patients undergoing painless gastroscopy from July 2024 to September 2024 were recruited. Patients were assigned to the obese group (body mass index [BMI]≥28 kg/m2, n=34) and non-obese group (18.5 kg/m2 ≤BMI<24 kg/m2, n=36). All patients received 0.1 μg/kg of sufentanil, and the ciprofol dose was determined by the modified Dixon sequential method with an initial dose of 0.4 mg/kg and a dose gradient of 0.01 mg/kg. The dose of ciprofol administered to the subsequent patient was determined by the response of the preceding patient. The response referred to the patient's cough, swallowing, and body movement during gastroscope insertion. The primary outcome was the ED50 of ciprofol in each group, while the secondary outcomes comprised the incidences of hypoxemia, hypotension, bradycardia, postoperative nausea and vomiting (PONV), and hemodynamic parameters.

Results: The ED50 of ciprofol was 0.278 mg/kg (95% confidence interval [CI]: 0.226-0.297 mg/kg) in the obese group and 0.347 mg/kg (95% CI: 0.329-0.360 mg/kg) in the non-obese group for gastroscopy sedation. The ED50 of ciprofol in the obese group was significantly lower than that in the non-obese group (P<0.05). The incidence of hypoxemia in the obese group was significantly higher than that in the non-obese group (P<0.05).

Conclusion: Obesity affected the ED50 of ciprofol, suggesting that the ciprofol dosage should be adjusted in obese patients.

Keywords: ciprofol; median effective dose; obesity; painless gastroscopy.

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Conflict of interest statement

All authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow diagram of included participants.
Figure 2
Figure 2
The up-and-down sequence of ciprofol dose for inhibiting responses to gastroscope insertion in non-obese patients. The black arrow represents crossover point (from “successful sedation” to “failed sedation”).
Figure 3
Figure 3
The up-and-down sequence of ciprofol dose for inhibiting responses to gastroscope insertion in obese patients. The black arrow represents crossover point (from “successful sedation” to “failed sedation”).
Figure 4
Figure 4
Dose-response curve of ciprofol for successful gastroscope insertion in non-obese patients.
Figure 5
Figure 5
Dose-response curve of ciprofol for successful gastroscope insertion in obese patients.
Figure 6
Figure 6
MAP from T0 to T4 in two groups. *P<0.05 compared to T0 in the non-obese patients. ***P<0.001 compared to T0 in the non-obese patients. ###P<0.001 compared to T0 in the obese patients.
Figure 7
Figure 7
HR from T0 to T4 in two groups. *P<0.05 compared to T0 in the non-obese patients. #P<0.05 compared to T0 in the obese patients.
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