Adjunctive Oliceridine During Propofol or Ciprofol Sedation for Same-Session Bidirectional Endoscopy in Older Adults: A Multicenter Randomized 2×2 Factorial Trial

Purpose

We evaluated adjunctive oliceridine with propofol or ciprofol in older adults undergoing same-session bidirectional endoscopy. Patients and methods: In this multicenter, double-blind, placebo-controlled 2×2 factorial trial, 360 adults aged 65-80 years were randomized 1:1:1:1 to oliceridine or saline placebo with propofol or ciprofol. The primary outcome was time from completion of the initial sedative dose to the first Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score of 5, confirmed by two subsequent scores of 5 at 1-min intervals. Main-effect comparisons were prespecified; interaction and simple-effect analyses were exploratory because the trial was not powered for interaction testing.