Application of cypropofol and propofol combined with low-dose alfentanil in gastroenteroscopy

To investigate the anesthetic effects and adverse effects of cypropofol and propofol combined with alfentanil, respectively, for gastroenteroscopy.

A total of 162 patients who underwent elective gastroenteroscopy at the Gastrointestinal Endoscopy Center of the First Hospital of Lanzhou University from January to February 2024 were enrolled, including 86 males and 76 females, at an age of 18~65 years old, with a BMI value of 18~30 kg/m², and ASA grade ≤Ⅱ. They were randomly divided into propofol group (Group P) and cypropofol group (Group C), with 81 cases in each group. All patients were sedated with 0.7 μg/kg alfentanil, and in 30 s later, 2 mg/kg propofol and 0.4 mg/kg cypropofol was intravenously dripped into Group P and Group C, respectively. When the modified alertness/sedation score (MOAA/S) ≤1, a gastroscope was started to insert. The related indicators, including total procedure time, successful cases of sedation, induction time and awakening time, heart rate, blood pressure, and pulse oximetry saturation were recorded, occurrence of adverse reactions such as hypotension, respiratory depression, injection pain, intraoperative body movement, nausea and vomiting were observed, and the satisfaction of endoscopists and of patients to anesthesia were recorded and compared between the 2 groups.

There were no statistical differences in the success rate of sedation, induction time and awakening time between the 2 groups. The patients of the Group C had more stable intraoperative vital signs, statistically lower incidences of injection pain, respiratory depression and hypotension (P < 0.05), and increased satisfaction for anesthesia (P < 0.05) when compared with those in Group P. No obvious difference were observed in the satisfaction of endoscopist to anesthesia between the 2 groups.

In combination with small-dose alfentanil, 0.4 mg/kg cypropofol shows similar sedation effect as 2 mg/kg propofol in gastroenteroscopy, with comparable induction and awakening time. Cypropofol has more advantages in stable intraoperative vital signs, less adverse effects such as low blood pressure, respiratory depression and injection pain, higher the patient satisfaction, which is worthy of clinical promotion.