Objective To investigate the anesthetic effect of ciprofol in the pediatric painless fiberoptic bronchoscopy. Methods A total of 114 pediatric patients scheduled for elective fiberoptic bronchoscopy were assigned to the propofol group, low-dose ciprofol group, and high-dose ciprofol group by using a random number table, with 38 cases in each group. For anesthesia induction: the propofol group received an intravenous injection of propofol at 2.0 mg/kg, the low-dose ciprofol group received an intravenous injection of ciprofol at 0.4 mg/kg, and the high-dose ciprofol group received an intravenous injection of ciprofol at 0.6 mg/kg. For anesthesia maintenance: the propofol group was administered a continuous intravenous infusion of propofol at 4-12 mg/(kg·h), while the low-dose ciprofol group and high-dose ciprofol group received a continuous intravenous infusion of ciprofol at 0.8-2.4 mg/(kg·h). The sedation success rate were assessed in the three groups. Additionally, heart rate, mean arterial pressure, and bispectral index were recorded at the following time points: before anesthesia induction (T0); at the first assessment after anesthesia induction when the Modified Observer's Assessment of Alertness/Sedation score was ≤1 point (T1); 1 minute after laryngeal mask airway insertion (T2); during the first lavage (T3); when the fiberoptic bronchoscope was withdrawn from the glottis (T4); and 5 minutes after discontinuation of all intravenous anesthetics (T5). Furthermore, the following parameters were recorded: anesthesia induction time; laryngeal mask airway extubation time; intraoperative dosages of propofol, ciprofol, and remifentanil; scores on the Pediatric Anesthesia Emergence Delirium Scale (PAED) and FLACC (Face, Leg, Activity, Cry, Consolability) at 10 minutes after laryngeal mask airway extubation; and the incidence of adverse reaction including injeaction pain. Result There were no statistically significant differences in the sedation success rate among the three groups (P>0.05). Compared with the low-dose ciprofol group, the profol group and high-dose ciprofol group had a shorter time to achieve a Modified Observer's Assessment of Alertness/Sedation score ≤1 point, and the high-dose ciprofol group had a higher proportion of pediatric patients who did not require rescue sedation during induction (P<0.05). Meanwhile, mean arterial pressure, heart rate, bispectral index, remifentanil dosage, and the scores of PAED and FLACC at 10 minutes after laryngeal mask airway extubation did not show any statistically significant difference among the three groups (P>0.05). The incidence of injection pain in the low-dose ciprofol group and high-dose ciprofol group was significantly lower than that in the propofol group (P<0.05). Conclusion Ciprofol for pediatric painless flexible bronchoscopy can achieve sedative efficacy and recovery quality similar to those of propofol, reduce the incidence of injection pain, and does not increase relevant adverse reactions. Additionally, 0.6 mg/kg ciprofol exhibits superior efficacy.

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