Combination of Sufentanil and Topiramate with Propofol for Sedation in Patients Undergoing Gastroscopy and Reducing Allergic Response

Propofol is widely used for sedation in upper gastrointestinal endoscopy but is associated with dose-dependent adverse effects such as hypotension, respiratory depression, and delayed recovery. This study evaluated the efficacy and safety of combining sufentanil and topiramate with propofol compared to propofol alone for procedural sedation during elective gastroscopy. In this prospective, randomized, double-blind clinical trial, 120 adult patients scheduled for elective upper gastrointestinal endoscopy were allocated to either a combination group (sufentanil + topiramate + propofol) or a control group (propofol only). Hemodynamic and respiratory parameters, total propofol dose, sedation depth, recovery time, adverse events, and patient and endoscopist satisfaction were recorded and compared between groups. The combination group required significantly lower total propofol doses and demonstrated improved hemodynamic stability, higher oxygen saturation, and shorter procedure and recovery times (p < 0.05 for all). The incidence of hypoxemia, hypotension, nausea, and other sedation-related complications was markedly reduced. Cognitive recovery and readiness for discharge were achieved faster in the combination group. Both patient and endoscopist satisfaction scores were significantly higher, reflecting smoother procedural conditions and greater overall comfort. The multimodal sedation regimen combining sufentanil and topiramate with propofol provides superior procedural safety, enhanced hemodynamic and respiratory stability, faster recovery, and greater satisfaction compared to propofol monotherapy. These findings support the adoption of this protocol as a safe and effective alternative for routine sedation in gastroscopy.