Authors: Wang S et al.
BMC Anesthesiology. 2026.
Summary
This population pharmacokinetic study examined the disposition of a single bolus dose of ciprofol in pediatric patients aged 1 to 9 years undergoing elective surgery. Ciprofol is a newer intravenous sedative–hypnotic with pharmacologic similarities to propofol, but pediatric bolus pharmacokinetic data have been limited. The authors aimed to characterize ciprofol pharmacokinetics in children and develop weight-based dosing guidance appropriate for this age group.
Twenty-seven children with ASA physical status I–II received a 0.6 mg/kg intravenous bolus of ciprofol administered over 30 seconds. An intensive sampling strategy was used, with thirteen arterial blood samples per patient. Plasma ciprofol concentrations were measured using ultra–high-performance liquid chromatography with mass spectrometry, and population pharmacokinetic modeling was performed using nonlinear mixed-effects techniques.
Ciprofol pharmacokinetics were best described by a three-compartment model. Pediatric patients demonstrated higher clearance and larger central volume of distribution per kilogram compared with adults, consistent with known developmental pharmacokinetic differences in children. Blood urea nitrogen was identified as a statistical covariate for central volume of distribution, but its effect on drug exposure was minimal and not clinically meaningful. After weight-based dosing, neither age nor body weight significantly influenced ciprofol pharmacokinetic parameters within the studied range.
Ciprofol was well tolerated, with no observed hemodynamic adverse events during the study period. Based on the modeled exposure profiles, a bolus dose of 0.6 mg/kg in children aged 1 to 9 years is expected to achieve exposures comparable to adults without increasing safety risk. These findings support the use of weight-based dosing for pediatric induction with ciprofol.
What You Should Know
Ciprofol clearance and central volume of distribution per kilogram are higher in children than in adults.
A three-compartment model accurately describes ciprofol pharmacokinetics in pediatric patients.
After weight-based dosing, age and body weight do not significantly affect ciprofol exposure in children aged 1–9 years.
A 0.6 mg/kg bolus dose provides appropriate exposure with good hemodynamic tolerability.
Key Points
Question: What are the pharmacokinetic characteristics of a single bolus dose of ciprofol in pediatric patients?
Findings: Children exhibit higher clearance and central volume of distribution per kilogram compared with adults, supporting higher weight-based dosing.
Meaning: A 0.6 mg/kg bolus dose of ciprofol appears appropriate for induction in children aged 1 to 9 years.
Thank you to BMC Anesthesiology for allowing us to summarize this article.