Ciprofol Dose Requirements for Successful Anesthesia Induction in Unpremedicated Children: An Up-and-Down Sequential Analysis

This investigation sought to identify the median effective dose (ED50) and the 90% effective dose (ED90) of ciprofol that can reliably provide sedation for the induction of general anesthesia in children, refine dosing recommendations, and support clinical decision-making. Children 3–12 years old scheduled for elective procedures requiring general anesthesia and endotracheal intubation were recruited. The initial participant received 0.4 mg/kg of intravenous ciprofol. Dose adjustments for all following subjects were made using the modified Dixon up-and-down design, with each new dose based on the prior child’s sedation outcome. Sedation was considered effective when both loss of eyelash reflex (LER) and facemask acceptance (AFM) occurred. ED50, ED90, and their 95% CI were calculated. Additional variables included the time until LER disappearance, induction-related vital sign alterations, and adverse reactions.

A total of 36 children completed the protocol, producing 7 success-to-failure crossover points. The ED50 and ED90 values for ciprofol were 0.618 (0.576–0.666) mg/kg and 0.708 (0.661–0.916) mg/kg, respectively. The eyelash reflex vanished at 31.04 ± 8.19 s on average. One episode of hypoxemia occurred; no injection discomfort or hypotension was noted. Ciprofol is effective for facilitating induction in pediatric patients between 3 and 12 years of age. In children without premedication, the ED50 for successful sedation is 0.618 mg/kg. A practical induction range is 0.6–0.7 mg/kg, which supports smoother mask-assisted breathing during the induction phase.