Etomidate-opioids show promising sedation balance for endoscopy

A systematic review and network meta-analysis of 152 trials involving 26,527 patients reveals no pharmacological regimen superior to propofol-opioids for sedation success in gastrointestinal endoscopy. However, etomidate-opioids ranked highest for sedation success, bradycardia, and recovery time, significantly reducing hypoxia risk compared to propofol-opioids. Esketamine-remimazolam exhibited superior hemodynamic stability and faster alertness but lower sedation success. Midazolam regimens were deemed ineffective due to prolonged recovery times.