Clinical Efficacy and safety of cyclopofol versus propofol combined with low-dose sufentanil in painless bronchoscopy

Abstract: Background: Painless bronchoscopy has become a common clinical procedure. Propofol, as a mainstream sedative, has problems such as respiratory and circulatory depression and injection pain. Propofol is a widely used sedative, is associated with adverse effects such as respiratory and circulatory depression and injection pain. Cyclopofol is a novel intravenous anesthetic developed in China that is associated with higher potency and a wider safety window, but controlled studies on its combination with opioids are still insufficient. Objectives: To compare the anesthetic efficacy, hemodynamic stability, respiratory effects and safety of cyclopofol combined with low-dose sufentanil versus propofol combined with low-dose sufentanil in painless bronchoscopy. Methods: 100 outpatients of American Society of Anesthesiologists (ASA) physical status class I or II were randomly assigned into group A (cyclopofol 0.4 mg/kg + sufentanil 0.1 μg/kg) and group B (propofol 1.5 mg/kg + sufentanil 0.1 μg/kg), with 50 patients in each group. Vital signs were monitored at predefined time points and the anesthesia duration, drug dosage, and adverse reactions were recorded. Results: Group A received a significantly lower total sedative dose, had a shorter onset time, faster recovery, and a higher Steward recovery score; the incidence of hypoxemia, injection pain, coughing and total adverse reactions was lower in Group A than in Group B and heart rate, blood pressure, and oxygen saturation showed smaller changes after induction and during glottic insertion. Conclusion: Cyclopofol combined with low-dose sufentanil was associated with a lower sedative dose, faster recovery, better recovery scores, and fewer adverse reactions than propofol combined with low-dose sufentanil. In addition, the proportion of patients rated as having excellent anesthesia was higher, according to the predefined assessment scale. Statistically significant differences were observed in most indicators, suggesting that cyclopofol may be a promising alternative for outpatient painless bronchoscopy.