Clinical Application Effect of Ciprofol Combined with Low-dose Esketamine in Painless Gastrointestinal Endoscopy

In patients undergoing painless gastrointestinal endoscopy, adding low-dose esketamine to ciprofol sedation resulted in more stable heart rate and blood pressure during the procedure compared with adding sufentanil. The esketamine group required less total sedative medication and fewer additional doses, spent less time in the recovery unit, and had a lower rate of adverse events (3.75% vs. 13.75%). Sedation success rates were similar between groups (98.75% vs. 96.25%). The findings suggest that low-dose esketamine as an adjuvant to ciprofol helps maintain hemodynamic stability, reduces sedative use, and lowers complication risk.

Study at a glance

Abstract

Objective: To investigate the clinical application effect of ciprofol combined with low-dose esketamine in painless gastrointestinal endoscopy. Methods: A retrospective analysis was conducted on the clinical data of 160 patients who underwent painless gastrointestinal endoscopy at the Digestive Endoscopy Center of Chengdu Integrated Traditional Chinese and Western Medicine Hospital from June 2023 to June 2024. The patients were divided into a control group (ciprofol + sufentanil, n=80) and a study group (ciprofol + esketamine, n=80) based on the anesthesia protocol they received. Hemodynamic indicators [mean arterial pressure (MAP), heart rate (HR), and blood oxygen saturation (SpO2)], anesthesia-related indicators, sedation effectiveness, and the incidence of adverse events were observed and compared between the two groups at different time points during the examination. Results: The fluctuations in HR and MAP at three time points (after induction, during endoscope insertion, and during the examination) were significantly smaller in the study group than in the control group (all P<0.05), indicating more stable hemodynamics. The total amount of sedative drugs used, the number of additional sedative doses administered, and the time spent in the post-anesthesia care unit were significantly lower in the study group than in the control group (all P<0.05). There was no significant difference in the success rate of sedation between the two groups (98.75% vs. 96.25%, P>0.05). The incidence of adverse events was lower in the study group than in the control group (3.75% vs. 13.75%, P<0.05). Conclusion: The use of low-dose esketamine as an adjuvant analgesic drug based on ciprofol sedation can effectively maintain hemodynamic stability, reduce the amount of sedative drugs used, facilitate rapid recovery of patients, and lower the risk of adverse events.