BACKGROUND: Although ciprofol is a novel intravenous anesthetic known for its respiratory and hemodynamic stability, its use in hysteroscopic endometrial polypectomy (HEP) has rarely been reported. Therefore, this study investigated the therapeutic potential of a novel combination of ciprofol and esketamine to reduce complications and enhance recovery after HEP.

MATERIAL AND METHODS: This prospective study enrolled 120 patients with endometrial polyps who underwent HEP. Participants were randomly assigned to receive either ciprofol plus esketamine (group CK, n=60) or ciprofol plus remifentanil (group CR, n=60). Two minutes after an initial bolus of esketamine (0.25 mg/kg) or remifentanil (1 μg/kg), all patients received a standardized ciprofol bolus (0.4 mg/kg). The primary endpoint was transient hypoxemia. Secondary outcomes were hemodynamic parameters, recovery time, ciprofol consumption, adverse events, gynecologist satisfaction, and postoperative Visual Analog Scale (VAS) scores.

RESULTS: Compared with CR, CK significantly reduced hypoxemia (1.7% vs 35.0%; P<0.001) and hypotension (16.7% vs 33.3%; P=0.035). Post-induction systolic blood pressure was lower in group CR (P=0.047), but other hemodynamic parameters were similar between groups. CK provided superior early analgesia (VAS at 10 min: 2.2±0.7 vs 2.9±0.9; P<0.001). Other outcomes were comparable (P>0.05).

CONCLUSIONS: The CK combination confers a clinical advantage over the CR combination for HEP. By mitigating the risk of hypoxemia and providing more effective short-term postoperative analgesia, the CK protocol represents a promising and potentially safer sedation regimen.

Keywords: Hemodynamics, hypoxemia