Ciprofol

With the rising number of elderly surgical patients, selecting an appropriate anesthetic tailored to their specific needs is essential. Ciprofol, a novel intravenous anesthetic, has garnered attention due to its low injection pain rate and minimal impact on the circulatory system. This meta-analysis aims to examine the efficacy and safety profile of ciprofol during perioperative management of elderly patients.

Comprehensive searches of PubMed, Embase, Cochrane, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases from inception to March 23, 2024, were conducted. Eligible studies were included, data extracted, quality assessed using the ROB2 tool, and analyses performed with Stata 17.0.

Analysis of eleven randomized controlled trials (RCTs) comprising 1715 patients demonstrated that ciprofol outperformed propofol regarding injection pain (RR: 0.13, 95% CI: 0.09-0.20, p < 0.001), hypotension (RR: 0.72; 95% CI: 0.56-0.94; p = 0.014), bradycardia (RR: 0.64, 95% CI: 0.48-0.85, p = 0.002), respiratory depression (RR: 0.29, 95% CI: 0.19-0.43, p < 0.001), hypoxemia (RR: 0.38, 95% CI: 0.26-0.55, p < 0.001), and body movement (RR: 0.73, 95% CI: 0.56-0.96, p = 0.022). No significant differences were observed in induction time(SMD: 0.11,95% CI: -0.39-0.61, p = 0.655), sedative success rate(RR:1.01,,:95% CI:0.97-1.06, p = 0.669)), time of leaving the operating room(SMD-0.21,95% CI: -0.83-0.40, p = 0.497), bucking(RR:0.56,:95% CI:0.27-1.17, p = 0.134)), nausea and vomiting(RR:0.69,95% CI:0.43-1.11, p = 0.143)).

Ciprofol demonstrates comparable efficacy to propofol in general anesthesia for elderly patients, with an enhanced safety profile, making it a viable clinical alternative. Further well-designed large RCTs are required to substantiate its safety profile.

The aim of this paper was to compare the impact of continuous infusion of ciprofol versus propofol on postoperative awakening in elderly patients following hip replacement surgery.

Patients were randomized into two groups (N.=45 each): the ciprofol group and the propofol group. The ciprofol group received ciprofol for anesthesia induction and maintenance, while the propofol group underwent anesthesia induction and maintenance using propofol. The primary outcome was awakening time. Secondary outcomes included spontaneous breathing recovery time, extubation time, time to modified Aldrete Score ≥9, modified observer's assessment of alertness/sedation (MOAA/S) scores, anesthetic dosage, volume of fluid replacement, urine output and administration of vasoactive drugs.

The Ciprofol group exhibited a significantly prolonged awakening time (11.0±6.4 min vs. 7.4±4.3 min, P=0.003), spontaneous breathing recovery time (9.9±6.3 min vs. 5.9±4.3 min, P=0.001), and extubation time (12.0 [8.0-16.0] min vs. 8.5 [6.0-11.0] min, P=0.005), and reduced requirement for intraoperative fluid replacement (728.9±254.2 mL vs. 908.3±287.5 mL, P=0.003), increased urine output (235.1±102.1 mL vs. 173.5±106.2 mL, P=0.007), decreased likelihood of vasoactive drug administration (15/30 vs. 28/14, P=0.002). No significant differences were observed between the two groups in terms of reaching a modified Aldrete Score ≥9, MOAA/S scores at 0, 5, 15, or 30 minutes post-extubation, or occurrence of adverse reactions (P>0.05). The dosage of remifentanil was significantly higher in the ciprofol group [5.4 (2.7-7.4) μg·kg^-1·h^-1 vs. 3.4 (1.9-4.3) μg·kg^-1·h^-1, P=0.004], with a mean maintenance dose of ciprofol at 0.8 mg·kg^-1·h^-1 (range: 0.5 to 1.2 mg·kg^-1·h^-1).

Compared to propofol, the administration of ciprofol in elderly patients following hip replacement surgery is associated with prolonged awakening time, spontaneous breathing recovery time, and extubation. The average intravenous maintenance dosage of ciprofol in geriatric patients under general anesthesia was 0.8 mg·kg^-1·h^-1.