Ciprofol versus propofol for painless gastrointestinal endoscopy: a dose-stratified systematic review and meta-analysis
In brief
Ciprofol cut reported injection pain by 87% in endoscopy trials
In 11 trials involving 2,084 adults, ciprofol was linked to fewer reported episodes of injection pain, hypotension, respiratory depression, and low oxygen than propofol, while procedural outcomes were broadly similar. Recovery took less than a minute longer on average. All trials were conducted in China, and varied methods and possible publication bias mean these safety differences need confirmation.
- Journal
- Frontiers in pharmacology (Q1)
- Published
- 25 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Jing Liu, Jun Yu, Zhiyong Chen, Yuchao Bai, Ximeng Zhang, Jian Du
- PMID
- 42856863
- DOI
- 10.3389/fphar.2026.1977897
Why clinicians should know about it
- Picked for Gastroenterology (top studies of the week, 11 October 2026): Ciprofol vs propofol for painless gastrointestinal endoscopy
Abstract
BACKGROUND: We compared ciprofol with propofol for painless gastrointestinal endoscopy, focusing on dose, recovery, induction, satisfaction, and adverse events. METHODS: PubMed and Embase were searched through May 2026 for randomized controlled trials in adults undergoing painless gastrointestinal endoscopy. We pooled weighted mean differences (WMDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes using random-effects models. Risk of bias was assessed with the Cochrane tool. The protocol was prospectively registered in PROSPERO (CRD420251088249). RESULTS: Eleven trials (2,084 participants) met the criteria. Recovery was statistically longer with ciprofol (WMD 0.83 min, 95% CI 0.16 to 1.49; P = 0.01), but the absolute difference was under 1 min; the difference was observed at 0.4 and 0.5 mg/kg. Induction time and physician and patient satisfaction did not differ significantly. Ciprofol was associated with fewer reported episodes of hypotension (RR 0.81, 95% CI 0.72-0.90), injection pain (RR 0.13, 95% CI 0.08-0.22), respiratory depression (RR 0.47, 95% CI 0.27-0.83), and hypoxemia (RR 0.64, 95% CI 0.42-0.96). CONCLUSION: Ciprofol and propofol produced broadly comparable procedural outcomes. The apparent advantages for selected adverse events and the dose-related recovery pattern are uncertain because all trials were conducted in China, several pooled outcomes were highly heterogeneous, outcome definitions varied, and publication bias was possible. The dose-stratified findings are exploratory, and the results are hypothesis-generating and require confirmation in larger international trials. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251088249, identifier PROSPERO CRD420251088249.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.