{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:48:41Z","timestamp":1781279321563,"version":"3.54.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to determine the 50% effective dose (ED50) of ciprofol when combined with different doses of remifentanil for upper gastrointestinal endoscopy of school-age children and to evaluate its safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study involved school-aged children who were scheduled to undergo upper gastrointestinal endoscopy under deep sedation. The children were randomly assigned to two groups: remifentanil 0.3\u00a0\u03bcg\/kg (R0.3) and remifentanil 0.5\u00a0\u03bcg\/kg (R0.5). Anesthesia was induced with remifentanil, followed by ciprofol. The dose of ciprofol for each patient was determined using the Dixon up-down sequential method. If the MOAA\/S score was \u22641 and the child did not exhibit significant movement or coughing during the endoscopy process, sedation was considered successful. The first patient in each group received 0.5\u00a0mg\/kg ciprofol. The dose of ciprofol was adjusted by 0.05\u00a0mg\/kg based on the response of the previous patient. The primary outcome was the ED50 of the ciprofol-induction dose. The total ciprofol doses, onset times, awakening times, and adverse reactions were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>1) The Dixon method was used to collect crossovers data from each group, and the ED50 values of the R0.3 and R0.5 groups were calculated to be 0.390\u00a0mg\/kg (95% CI 0.356\u20130.424\u00a0mg\/kg) and 0.332\u00a0mg\/kg (95% CI 0.291\u20130.374\u00a0mg\/kg), respectively. The ED50 of ciprofol in the R0.3 group was significantly higher than that in the R0.5 group (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). 2) The onset time and recovery time of the R0.5 group were shorter than those of the R0.3 group (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). When the two groups were compared, the total dose of ciprofol in the R0.5 group decreased (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). 3) Compared with the R0.3 group, the incidence of respiratory depression during induction in the R0.5 group increased (<jats:italic>p<\/jats:italic> &amp;lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study explored the ED50 of ciprofol combined with different doses of remifentanil for successful sedation in upper gastrointestinal examinations in school-aged children. Compared to the use of remifentanil 0.3\u00a0\u03bcg\/kg, the combination of ciprofol with remifentanil 0.5\u00a0\u03bcg\/kg significantly reduced the ED50 required to prevent body movement or cough during endoscope insertion but increased the incidence of respiratory depression.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2024.1386129","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T04:36:48Z","timestamp":1728621408000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["ED50 of ciprofol combined with different doses of remifentanil during upper gastrointestinal endoscopy in school-aged children: a prospective dose-finding study using an up-and-down sequential allocation method"],"prefix":"10.3389","volume":"15","author":[{"given":"Xu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haicheng","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueyi","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s12871-024-02479-9","article-title":"Efficacy and safety of ciprofol versus propofol for anesthesia induction in adult patients received elective surgeries: a meta analysis","volume":"24","author":"Ainiwaer","year":"2024","journal-title":"BMC Anesthesiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"111425","DOI":"10.1016\/j.jclinane.2024.111425","article-title":"Efficacy and safety of Ciprofol compared with Propofol during general anesthesia induction: a systematic review and meta-analysis of randomized controlled trials (RCT)","volume":"94","author":"Akhtar","year":"2024","journal-title":"J. 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