Respiratory and circulatory safety of ciprofol combined with remifentanil during fiberoptic bronchoscopy in Chinese patients with tuberculosis: a randomized, double-blind, controlled trial

To investigate the respiratory and circulatory safety of ciprofol administered during fiberoptic bronchoscopy in Chinese patients with tuberculosis. This double-blind, randomized clinical study was conducted in 64 Chinese patients with tuberculosis who underwent fiberoptic bronchoscopy. All patients were randomly allocated to Group C (n = 32) and Group H (n = 32). In Group C, propofol (2 mg/kg) and remifentanil (0.5 μg/kg) were injected intravenously, while in Group H, ciprofol (0.4 mg/kg) and remifentanil (0.5 μg/kg) were injected. Primary indicators: (1) incidence of hypoxemia and hypotension. (2) Patient’s heart rate (HR), blood pressure (systolic blood pressure and diastolic blood pressure, SBP/DBP), saturation of pulse oximetry (SPO2), and respiratory rate (RR) at different time points. Time points: anesthesia induction (T0), successful induction of anesthesia (T1), expose glottis (T2), entry into the carina (T3), and fully awake (T4). Secondary indicators: (1) induction duration; (2) coughing score; (3) incidence of injection pain; (4) patient satisfaction. In terms of respirator safety, there were no significant differences between those two groups in the incidence of hypoxemia (P > 0.025) and SPO2 (P > 0.0125). But the RR in Group H was significantly elevated compared with Group C at T1, T2, T3 and T4 (P < 0.0125). In terms of circulatory safety, Group H showed a significantly lower incidence of hypotension (P < 0.025) compared with Group C. The HR of Group H at T2, T3 and T4 was higher than that of Group C (P < 0.0125). The SBP of Group C at T1, T2 and T3 was significantly decreased than that of Group H (P < 0.0125), and the DBP of Group C at T1, T2 and T4 was significantly decreased than that of Group H (P < 0.0125). In addition, the induction duration of Group H was significantly lower than that of Group C (P < 0.05). Compared with Group C, Group H exhibited significantly reduced incidences of coughing score and injection pain (P < 0.05). Patient satisfaction was significantly higher in Group H than in Group C (P < 0.05). In Chinese patients with tuberculosis who underwent fiberoptic bronchoscopy, ciprofol exhibited better circulatory safety profiles than propofol. However, there was no demonstrated superiority in the aspect of respirator safety. Meanwhile, ciprofol reduced the incidences of coughing and injection pain, and provided higher satisfaction than propofol. Trial registration 29 /07/ 2024, ChiCTR2400087524