Ciprofol versus Propofol Combined with Alfentanil for Respiratory Adverse Events in Overweight Patients Undergoing Painless Gastroscopy: A Randomized Controlled Trial.

Purpose: Respiratory management remains a major challenge during painless endoscopy in overweight or obese patients because of altered body fat distribution and reduced pulmonary reserve. This study evaluated whether ciprofol could reduce respiratory adverse events compared with propofol during painless gastroscopy in this population. Methods: In this single-center, prospective, single-blind randomized controlled trial, 106 overweight or obese patients undergoing painless gastroscopy were randomly assigned (1:1) to receive either propofol (2 mg/kg) or ciprofol (0.4 mg/kg) following intravenous alfentanil (5 μg/kg). The primary outcome was the overall incidence of respiratory adverse events from anesthesia induction to completion of endoscopy, including hypoxemia (SpO Results: A total of 106 patients completed the study (53 per group). The incidence of respiratory adverse events was significantly lower in the ciprofol group than in the propofol group (33.96% vs. 66.04%, P=0.001). The lowest intraoperative SpO Conclusion: In overweight or obese patients undergoing painless gastroscopy, ciprofol at 0.4 mg/kg significantly reduced respiratory adverse events, improved oxygenation, and decreased injection pain compared with propofol. These findings suggest that ciprofol may be a preferable anesthetic option for painless endoscopy in this population. Clinical Trial Registration: ChiCTR2600117367.