Comparative Efficacy and Safety of Ciprofol Versus Propofol in Adults Undergoing Fiberoptic Bronchoscopy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Background: Ciprofol, a novel intravenous sedative, has recently gained increasing clinical attention for procedural anesthesia. Emerging evidence suggests it may possess potential safety advantages over propofol. This study aimed to systematically compare the efficacy and safety of ciprofol and propofol for sedation in patients undergoing fiberoptic bronchoscopy. Methods: A comprehensive literature search was conducted in eight electronic databases. Statistical analyses were performed using the R software (version 4.5.2). The risk ratio (RR) with 95% confidence interval (CI) was used for dichotomous outcomes, and the mean difference (MD) with 95% CI was used for continuous outcomes. Results: This meta-analysis included 22 RCTs with 2452 participants. Compared with propofol, ciprofol significantly reduced the incidence of hypotension (RR, 0.39; 95% CI, 0.28–0.55), injection pain (RR, 0.14; 95% CI, 0.10–0.19), hypoxemia (RR, 0.56; 95% CI, 0.35–0.90), and respiratory depression (RR, 0.23; 95% CI, 0.12–0.43). No significant differences were found in cough (RR, 1.01; 95% CI, 0.89–1.14), bradycardia (RR, 0.69; 95% CI, 0.42–1.14), nausea and vomiting (RR, 0.84; 95% CI, 0.56–1.27), induction time (MD, 0.03; 95% CI, −10.57–10.62), operation time (MD, −0.3060; 95% CI, −0.6127–0.0008), recovery time (MD, 0.10; 95% CI, −0.59–0.79), or procedural success rate (RR, 1.00; 95% CI, 0.99–1.01). Conclusions: Ciprofol provides comparable sedative efficacy to propofol for fiberoptic bronchoscopy, while reducing the incidence of adverse events, suggesting it may be a favorable alternative.