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已发表论文
环泊酚联合艾司氯胺酮或舒芬太尼用于老年内镜黏膜下剥离术患者的 ED95：一项剂量探索和随机对照试验
Authors Qin X, Jiang H, Xie Y, Liu Q , Zhang Y, Mamtili I
Received 11 January 2026
Accepted for publication 29 January 2026
Published 4 February 2026 Volume 2026:20 595458
DOI https://doi.org/10.2147/DDDT.S595458
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Anastasios Lymperopoulos
Xiaoxue Qin, Hui Jiang, Yan Xie, Qian Liu, Yaodan Zhang, Ilyar Mamtili
Department of Anesthesiology, Shanghai Xuhui Central Hospital, Shanghai, People’s Republic of China
Correspondence: Ilyar Mamtili, Department of Anesthesiology, Shanghai Xuhui Central Hospital, Shanghai, People’s Republic of China, Email ilyarm@163.com
Background: This study aimed to estimate the 95% effective dose (ED95) of ciprofol when combined with esketamine or sufentanil in elderly patients undergoing endoscopic submucosal dissection (ESD), and to explore the associated clinical and safety profiles of these sedation strategies.
Methods: This study was conducted in two phases. In Phase 1, 44 patients aged 65– 80 years undergoing ESD were randomized to receive ciprofol combined with esketamine (group E) or sufentanil (group S). Dixon’s up-and-down method was used to characterize the dose-response relationship of ciprofol, and ED95 values were derived as model-based estimates. In Phase 2, 68 patients were randomized to group E or group S. Phase 2 was designed as an exploratory randomized comparison, and intraoperative parameters, hemodynamic variables, and postoperative outcomes were recorded.
Results: Based on model-based analysis, the estimated ED95 of ciprofol combined with esketamine was 0.276 mg/kg (95% CI: 0.264– 0.349), while that combined with sufentanil was 0.244 mg/kg (95% CI: 0.236– 0.282). No significant differences were observed between the two groups in the proportion of patients requiring rescue sedation or analgesia (P > 0.05). Induction time was shorter in group E than in group S (P = 0.039). During the procedure, group E showed lower incidences of hypoxia and hypotension and less fluctuation in mean arterial pressure (MAP) and heart rate (HR) compared with group S (P < 0.05). In contrast, the time to full alertness was longer in group E than in group S (P = 0.012).
Conclusion: Ciprofol combined with esketamine or sufentanil showed different clinical and hemodynamic profiles in elderly patients undergoing ESD. These findings were derived from an exploratory analysis and should be interpreted as strategy-specific rather than evidence of superiority. The longer time to full alertness with esketamine indicates a potential trade-off.
Trial Registration: Chictr.org.cn; identifier: ChiCTR2500102341.
Keywords: ciprofol, esketamine, sufentanil, endoscopic submucosal dissection, elderly
Department of Anesthesiology, Shanghai Xuhui Central Hospital, Shanghai, People’s Republic of China
Correspondence: Ilyar Mamtili, Department of Anesthesiology, Shanghai Xuhui Central Hospital, Shanghai, People’s Republic of China, Email ilyarm@163.com
Background: This study aimed to estimate the 95% effective dose (ED95) of ciprofol when combined with esketamine or sufentanil in elderly patients undergoing endoscopic submucosal dissection (ESD), and to explore the associated clinical and safety profiles of these sedation strategies.
Methods: This study was conducted in two phases. In Phase 1, 44 patients aged 65– 80 years undergoing ESD were randomized to receive ciprofol combined with esketamine (group E) or sufentanil (group S). Dixon’s up-and-down method was used to characterize the dose-response relationship of ciprofol, and ED95 values were derived as model-based estimates. In Phase 2, 68 patients were randomized to group E or group S. Phase 2 was designed as an exploratory randomized comparison, and intraoperative parameters, hemodynamic variables, and postoperative outcomes were recorded.
Results: Based on model-based analysis, the estimated ED95 of ciprofol combined with esketamine was 0.276 mg/kg (95% CI: 0.264– 0.349), while that combined with sufentanil was 0.244 mg/kg (95% CI: 0.236– 0.282). No significant differences were observed between the two groups in the proportion of patients requiring rescue sedation or analgesia (P > 0.05). Induction time was shorter in group E than in group S (P = 0.039). During the procedure, group E showed lower incidences of hypoxia and hypotension and less fluctuation in mean arterial pressure (MAP) and heart rate (HR) compared with group S (P < 0.05). In contrast, the time to full alertness was longer in group E than in group S (P = 0.012).
Conclusion: Ciprofol combined with esketamine or sufentanil showed different clinical and hemodynamic profiles in elderly patients undergoing ESD. These findings were derived from an exploratory analysis and should be interpreted as strategy-specific rather than evidence of superiority. The longer time to full alertness with esketamine indicates a potential trade-off.
Trial Registration: Chictr.org.cn; identifier: ChiCTR2500102341.
Keywords: ciprofol, esketamine, sufentanil, endoscopic submucosal dissection, elderly