Ciprofol versus propofol for general anesthesia during thoracoscopic surgery: a randomized double-blind trial

Ciprofol is a novel intravenous anesthetic with potentially improved hemodynamic stability and fewer injection-related adverse effects than propofol. This study compared ciprofol and propofol for general anesthesia in patients undergoing video-assisted thoracoscopic surgery (VATS).

In this prospective, randomized, double-blind trial, 120 adults undergoing elective thoracoscopic surgery were randomized to ciprofol (n = 60) or propofol (n = 60). MAP, HR, and BIS were assessed at eight predefined perioperative time points using linear mixed-effects models. The repeated binary outcome of BIS ≥60 was analyzed using a generalized linear mixed-effects model. Induction characteristics, injection pain, recovery profiles, and perioperative adverse events were also evaluated.

MAP differed significantly between groups, with higher values in the ciprofol group at loss of consciousness and after tracheal intubation. HR was modestly higher at selected early time points, without a significant group-by-time interaction. BIS was higher with ciprofol during the early intraoperative period, and BIS ≥60 was more frequent at loss of consciousness (76.7% vs. 43.3%, p < 0.001), but not thereafter. Ciprofol was associated with shorter induction time (38.3 vs. 46.0 s, p < 0.001), less injection pain (5.0% vs. 20.0%, p = 0.025), and shorter PACU stay (48.0 vs. 55.7 min, p = 0.011). No significant differences were observed in supplemental anesthetic requirements, emergence time, or perioperative adverse events.

Ciprofol showed a perioperative profile broadly comparable to propofol, with transient differences in hemodynamic parameters and higher BIS during the early intraoperative period. Ciprofol was associated with faster induction, less injection pain, and shorter PACU stay. Larger multicenter studies are warranted to confirm these findings.

https://www.chictr.org.cn/showproj.html?proj=203394, Identifier: ChiCTR2400082924.