Effect of ciprofol- and propofol-induced sedation for gastrointestinal endoscopy on pharyngeal swallowing function: A prospective experimental study

AbstractBackground Ciprofol and propofol are equally safe and effective in enabling patients to undergo painless gastroscopy. However, the effects of ciprofol on swallowing have not been reported. We aimed to compare the effects of ciprofol and propofol on pharyngeal swallowing function in patients undergoing gastrointestinal endoscopy. Methods We randomly divided 237 patients aged 22–64 years with American Society of Anesthesiologists class I–II undergoing gastrointestinal endoscopy into the ciprofol (Group C, n = 116) or propofol (Group P, n = 121) group. Patients in Group C and Group P received an intravenous bolus injection of 0.6 mg/kg ciprofol and 2.5 mg/kg propofol, respectively, with the injection time exceeding 30 s. Endoscopy was performed when the Modified Observer's Assessment of Alertness/Sedation score was ≤ 1. The primary outcome was the incidence of severe dysphagia. The Penetration and Aspiration Scale score, Dysphagia Severity Score, occurrence of laryngeal adductor reflex, and arytenoid joint laxity were recorded. The secondary outcomes included the time spent in the post-anesthesia care unit, postoperative recovery time, and incidence of gag reflex, body movement, respiratory depression, hypotension, and postoperative dizziness. Results Group C had a significantly higher incidence of the laryngeal adductor reflex than Group P (54.2% vs. 34.2%, < 0.05), while the incidence of severe dysphagia in Group C was lower than that in Group P (12.9% vs. 33.1%, P < 0.05). The incidence of body movements in Group C was lower than that in Group P (15.5% vs. 31.4%, P < 0.05). Conclusions Compared with propofol, ciprofol may be more beneficial in retaining partial pharyngeal swallowing function to reduce body movements and the risk of aspiration; however, the mechanism requires further investigation. Trial registration: This trial was registered with the China Clinical Trials Centre (Registration Number: ChiCTR2100054446, registration date: 17/12/2021).