Work

The 90% effective dose of ciprofol and propofol with S-ketamine for painless abortion: a randomized, double-blind, sequential dose-finding trial

Year: 2025

Type: article

Abstract: Background: Unlike the propofol–opioids combination, a single dose of S-ketamine with propofol achieves the same anesthetic effects while effectively minimizing adverse reactions in painless abortion. Ciprofol, a novel analog of propofol, has distinct advantages, its application in painless abortion is underexplored. Objectives: To investigate a 90% effective dose (ED 90 ) of ciprofol and propofol with S-ketamine for painless abortion. Design: This prospective biased coin up-and-down (BCUD) sequential dose-finding study aimed to estimate the ED 90 of ciprofol when administered with 0.15 mg/kg S-ketamine in painless abortion while comparing adverse effects incidence with the ED 90 of propofol when combined with the same dose of S-ketamine. Methods: Eighty patients were recruited and randomly allocated to either ciprofol or propofol groups, with initial doses of 0.375 mg/kg and 1.5 mg/kg, respectively. The dose for the subsequent patient in the study was based on the response of the preceding patient, following the BCUD design. The study estimated the ED 90 using isotonic regression. Secondary outcomes, including the incidence of injection pain, vital signs, and adverse events, were recorded and compared between the two groups. Results: The ED 90 of ciprofol with 0.15 mg/kg S-ketamine was 0.498 mg/kg (95% confidence interval: 0.498–0.510), while the ED 90 of propofol with 0.15 mg/kg S-ketamine was 1.99 mg/kg (95% confidence interval: 1.98–2.16). Patients in the ciprofol group had a lower incidence of respiratory pause (7.5% vs 52.5%; p < 0.001). Other adverse events and recovery time were comparable between groups. Conclusion: Compared to propofol and S-ketamine combination, ciprofol and S-ketamine are equally effective with reduced respiratory depression. Thus, clinicians should consider a dose of 0.5 mg/kg ciprofol with 0.15 mg/kg S-ketamine for painless abortion. Trial registration: http://www.chictr.org.cn ; ChiCTR2400086522; July 5, 2024.

Source: Therapeutic Advances in Drug Safety

DOI: 10.1177/20420986251328673

Authors: Qiang Tao, Qiao Shi, Tao Xu, Shanshan Ye

Institutions: Shanghai Jiao Tong University, International Peace Maternity & Child Health Hospital

Language: English

Topic: Anesthesia and Sedative Agents

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,800