Table 2 Summary of findings of randomized controlled trials (RCT) comparing ciprofol (C) and propofol (P) for sedation or general anesthesia (GA)

Zhong et al.

J Clin Anesth 2023 [30]

Sedation for FB or ERCP or ESD:

C6 (6 mg/kg/h) (n = 69)

C8 (8 mg/kg/h) (n = 69)

P4 (4 mg/kg/h) (n = 69)

Onset: Comparable in ESD and ERCP (p = 0.19 and p = 0.07): FB: C6 = 3.3 ± 1.0; C8 = 2.9 ± 0.6; P4 = 2.5 ± 0.6 (p = 0.004)

Offset: Comparable in all: ESD (p = 0.17); ERCP (p = 0.47); FB (p = 0.15)

Adverse events: C and P induced similar adverse events

Pain incidence: C6 and C8 both 0%; P4 = 4.3%

Chen et al.

Contrast Media Mol Imaging 2022 [31]

Sedation for painless gastroenteroscopy:

C: 0.4 mg/kg (n = 47)

P: 1.5–2.0 mg/kg (n = 49)

Onset: C: 3.0 ± 0.8 vs P: 1.1 ± 0.4 (p < 0.01)

Offset: C: 6.2 ± 1.6 vs P: 3.1 ± 2.1 (p < 0.01)

Adverse events: C: 53.2% vs P: 63.3% (p < 0.05)

Injection pain: C: 2.1% vs P: 71.4% (p < 0.05)

Wu et al.

Front Pharmacol 2022 [29]

Sedation for FB:

C: 0.3 mg/kg (n = 46)

P: 1.2 mg/kg (n = 46)

Onset: C: 0.6 ± 0.3 vs P: 0.6 ± 0.3 (p = 0.69)

Offset: C: 4.7 ± 1.4 vs P: 4.7 ± 1.9 (p = 0.95)

Hypotension: C: 10.9% vs P: 26.1% (p = 0.06)

Hypertension: C: 8.7% vs P: 8.7% (p = 1.0)

Bradycardia: C: 6.5% vs P: 10.9% (p = 0.71)

Arrhythmia: C: 10.9% vs P: 6.5% (p = 0.71)

Injection pain: C: 6.5% vs P: 37.0% (p < 0.01)

Luo et al.

CNS Drugs 2022 [25]

Sedation for FB:

C: 0.4 mg/kg (n = 134)

P: 2 mg/kg (n = 133)

Onset: C: 1.00 (0.5–3.5) vs P: 1.0 (0.4–8.0) (p = 0.06)

Offset: C: 14.3 (4.8–30.3) vs P: 11.9 (4.5–35.8) (p = 0.001)

Hypotension: C: 20.7% vs P: 27.3% (p = 0.21)

Bradycardia: C: 5.9% vs P: 6.8% (p = 0.76)

Injection pain: C: 4.4% vs P 39.4% (p < 0.001)

Teng et al.

Eur J Pharm Sci 2021 [16]

Sedation for colonoscopy:

C0.4: 0.4 mg/kg (n = 31)

C0.5: 0.5 mg/kg (n = 32)

P: 2.0 mg/kg (n = 31)

Onset (colonoscopy insertion): C0.4: 1.6 ± 0.5, C0.5: 1.2 ± 0.4 vs P: 1.2 ± 0.6 (p < 0.01)

Offset (full alertness): C0.4: 12.1 ± 2.7, C0.5: 16.4 ± 3.9 (p = 0.02; C0.4 vs C0.5) vs P: 11.6 ± 3.0 (p = 0.004; C vs P)

Time to discharge: C0.4: 12.3 ± 2.6, C0.5: 16.8 ± 4.1 (p = 0.015; C0.4 vs C0.5) vs P: 11.6 ± 3.0 (p = 0.006; C vs P)

Adverse events: C0.4: 83.9%, C0.5: 68.9%, P: 68.8% (p = 0.30)

Hypotension: C0.4 and C0.5 both 20.4%, P: 20.8% (p = 0.90)

Injection pain: C0.4: 12.9%, C0.5: 6.3%, P: 45.2%

Li et al.

Basic Clin Pharmacol Toxicol 2022 [27]

Sedation for colonoscopy or gastroscopy

C: 0.4 mg/kg (n = 145)

P: 1.5 mg/kg (n = 144)

Onset: C: 1.1 ± 0.5 vs P: 1.1 ± 0.4 (p = 0.40)

Offset: C: 3.3 ± 3.1 vs P: 2.0 ± 2.1 (p < 0.001)

Adverse events: C: 31.3% vs P: 62.8% (p < 0.001)

Injection pain: C: 4.9% vs P: 52.4% (p < 0.001)

Lan et al.

Drug Des Devel Ther 2023 [28]

Sedation for hysteroscopy, induction/maintenance:

C: 0.4 mg/kg followed by 0.6–1.2 mg/kg/h (n = 75)

P: 2.0 mg/kg followed by 3.0–6.0 mg/kg/h (n = 75)

Onset: C: 1.4 ± 0.9 vs P:1.2 ± 0.5 (p = 0.02)

Offset: C: 5.4 ± 2.7 vs P: 4.6 ± 1.9 (p = 0.06)

Hypotension: C: 40% vs P: 68.9% (p < 0.05)

Respiratory adverse events: C: 4.0% vs P: 31.1% (p < 0.05)

Injection pain: C: 0% vs P:27.0% (p < 0.05)

Chen et al.

Drug Des Devel Ther 2023 [26]

Sedation for gastrointestinal endoscopy

C0.2: 0.2 mg/kg (n = 38)

C0.3: 0.3 mg/kg (n = 36)

C0.4: 0.4 mg/kg (n = 31)

P: 1.5 mg/kg (n = 44)

Onset: C0.2: 42.6 ± 14.5, C0.3: 43.3 ± 20.0, C0.4: 52.6 ± 18.6 vs P: 85.4 ± 56.0 (p < 0.001)

Offset: No difference in time of wake up between groups (p > 0.05)

Hypotension and bradycardia: Reduced in C 1 and C 2 (p < 0.05)

PONV: C0.2, C0.3, and C0.4: 0%, P: 4.5% (p < 0.05)

Respiratory depression: C0.2 and C0.3 0%, C0.4: 12.9%, P: 9.1% (p < 0.05)

Injection pain: C0.2, C0.3, and C0.4: 0%, P: 11.4% (p < 0.05)

Wang et al.

Eur Rev Med Pharmacol Sci 2022 [24]

GA induction:

C: 0.4 mg/kg (n = 88)

P: 2 mg/kg (n = 88)

Onset: C = 0.9 ± 0.03 vs P = 0.8 ± 0.03 (p < 0.05)

Offset: -

Adverse events: C = 88.6% vs P = 95.5%, p = 0.16

Injection pain: C = 6.8% vs P = 20.5%, p < 0.05

Qin et al.

Eur Rev Med Pharmacol Sci 2022 [23]

GA kidney transplantation, induction/maintenance:

C: 0.4 mg/kg followed by 0.8–2.4 mg/kg/h (n = 52)

P: 2.0 mg/kg; followed by 4–12 mg/kg/h (n = 53)

Onset (s): C: 33.6 vs P: 39.1 (p < 0.001)

Offset: C: 44.8 vs P = 28.1 (p < 0.001)

Hypotension: C = 3.8% vs P = 20.8 (p = 0. 009)

Bradycardia: C = 13.5% vs P = 26.4% (p = 0.097)

Injection pain: C = 6.8% vs P = 20.5%, p = 0.01)

Zeng et al.

Eur Rev Med Pharmacol Sci 2022 [22]

GA (elective surgery), induction/maintenance:

C: 0.4 mg/kg followed by 0.8 mg/kg/h (n = 30)

P: 2.0 mg/kg followed by 6 mg/kg/h (n = 10)

Mix: P 2.0 mg/kg followed by C 1 mg/kg/h (n = 6)

Onset (s): C: 45.3 ± 0.14.8 vs P: 42.3 ± 15.3 vs mix: 56.7 ± 13.7 (p = 0.84)

Offset: C: 11.4 ± 0.4.9 vs P: 11.8 ± 3.4 vs mix: 13.5 ± 4.6 (p = 0.57)

Hypotension: C: 46.7% vs P: 50% vs mix: 66.7% (p > 0.05)

Bradycardia: C: 26.7% vs P: 20% vs mix: 50% (p > 0.05)

Injection pain: -

Liang et al.

Eur J Anaesthesiol 2023 [21]

GA, induction/maintenance:

C: 0.4 mg/kg followed by 0.8 mg/kg/h (n = 86)

P: 2.0 mg/kg followed by 5 mg/kg/h (n = 42)

Onset: C: 0.8 ± 0.3 vs P: 0.8 ± 0.2 (p = 0.58)

Offset: C: 10.0 ± 3.9 vs P: 10.01 ± 4.7 (p = 0.74)

Hypotension: C: 30.2% vs P: 28.6% (p = 1.00)

Bradycardia: C: 20.9% vs P: 21.4% (p = 1.00)

Injection pain: C: 8.1% vs P: 21.4% (p = 0.046)

Man et al.

BMC Anesthesiol 2023 [20]

GA (gynecology surgery), induction/maintenance:

C: 0.5 mg/kg followed by 1 mg/kg/h (n = 64)

P: 2.0 mg/kg followed by 5 mg/kg/h (n = 64)

Onset: C: 1.6 ± 0.4 vs P: 1.4 ± 0.2 (p < 0.05)

Offset: C: 5.4 ± 2.8 vs P: 4.6 ± 1.6 (p = 0.72)

Adverse events: C: 56.2% vs P: 92.2% (p < 0.05)

Injection pain: C: 1.6% vs P: 76.6% (p < 0.001)

Chen et al.

BMC Anesthesiol 2022 [19]

GA (gynecology surgery). Induction with midazolam (0.03 mg/kg), sufentanil (0.3 μg/kg):

C: 0.4 mg/kg (n = 60)

P: 2.0 mg/kg (n = 60)

Onset (s): C: 33.7 ± 10.6 vs P: 34.0 ± 6.5 (p = 0.86)

Offset: -

Adverse events: C: 20% vs P: 48.3% (p = 0.002)

Injection pain: C: 16.7% vs P: 58.3% (p < 0.001)