Academic Journal
Post-Intubation Hypotension After Titrated Induction with Ciprofol versus Propofol in Older Adults Undergoing Non-Cardiac Surgery: A Randomized Controlled Trial.
| Τίτλος: | Post-Intubation Hypotension After Titrated Induction with Ciprofol versus Propofol in Older Adults Undergoing Non-Cardiac Surgery: A Randomized Controlled Trial. |
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| Συγγραφείς: | Bai H; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Guo J; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Li Y; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Zhang S; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Chen S; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Wang Z; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Lu K; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Zhang L; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Zhong F; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Gong R; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Li J; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Han J; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Song X; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China., Jin S; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China. |
| Πηγή: | Clinical interventions in aging [Clin Interv Aging] 2026 Aug 22; Vol. 21, pp. 609412. Date of Electronic Publication: 2026 Aug 22 (Print Publication: 2026). |
| Τύπος έκδοσης: | Journal Article; Randomized Controlled Trial; Comparative Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Dove Medical Press Country of Publication: New Zealand NLM ID: 101273480 Publication Model: eCollection Cited Medium: Internet ISSN: 1178-1998 (Electronic) Linking ISSN: 11769092 NLM ISO Abbreviation: Clin Interv Aging Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Auckland : Dove Medical Press |
| Ιατρικοί όροι (MeSH): | Propofol*/adverse effects , Propofol*/administration & dosage , Hypotension*/chemically induced , Hypotension*/etiology , Anesthetics, Intravenous*/adverse effects , Anesthetics, Intravenous*/administration & dosage , Intubation, Intratracheal*/adverse effects, Norepinephrine/administration & dosage ; Humans ; Aged ; Female ; Double-Blind Method ; Male ; Prospective Studies ; Aged, 80 and over ; Geriatric Anesthesia ; Cyclopropanes |
| Περίληψη: | Purpose: To compare ciprofol with propofol for titrated induction of anesthesia in older adults undergoing non-cardiac surgery, with a focus on post-intubation hypotension and related hemodynamic burden. Methods: In this prospective, randomized, double-blind trial, adults aged 65-89 years undergoing elective non-cardiac surgery were randomly assigned in a 1:1 ratio to receive either ciprofol or propofol, following an identical titration-to-effect induction protocol. The primary outcome was post-intubation hypotension, defined as any mean arterial pressure (MAP) ≤ 65 mmHg during the 15-minute period after successful tracheal intubation and before surgical incision. Secondary outcomes included hypotension burden expressed as area under the curve (AUC), norepinephrine requirement, cardiac output trajectories, time to loss of consciousness, and early postoperative recovery outcomes. Results: 160 patients were randomized. Post-intubation hypotension occurred less frequently in the ciprofol group than in the propofol group (28/77 [36.3%] vs 53/79 [67.0%]; adjusted odds ratio 0.28, 95% confidence interval [CI] 0.15-0.54; P < 0.001), consistent across BIS-adjusted sensitivity analyses. Ciprofol was also associated with a lower AUC for MAP ≤ 65 mmHg (0.0 [0.0-3.2] vs 2.5 [0.0-14.8] mmHg min; P = 0.047), reduced norepinephrine requirement (0.0 [0.0-10.0] µg vs 10.0 [0.0-20.0] µg; P < 0.001), and milder early cardiac output decline (group-by-time interaction β = -0.008, 95% CI -0.010 to -0.005; P < 0.001). No significant between-group differences were observed in early postoperative adverse outcomes. Conclusion: In this single-center trial of older adults undergoing non-cardiac surgery, ciprofol-based titrated induction was associated with less post-intubation hypotension, lower rescue vasopressor requirement, and less cumulative hypotensive exposure than propofol, without an apparent increase in early adverse recovery outcomes. These findings suggest a favorable hemodynamic profile of ciprofol, which requires confirmation in larger multicenter studies. (© 2026 Bai et al.) |
| Competing Interests: | The authors declare no conflicts of interest regarding this work. This study received no financial support from Haisco Pharmaceutical Group or any other pharmaceutical manufacturers. |
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| Contributed Indexing: | Keywords: ciprofol; older adults; post-intubation hypotension; propofol; titration-to-effect |
| Substance Nomenclature: | YI7VU623SF (Propofol) 0 (Anesthetics, Intravenous) X4W3ENH1CV (Norepinephrine) 0 ((2-(1R)-1-cyclopropyl)ethyl-6-isopropyl-phenol) 0 (Cyclopropanes) |
| Entry Date(s): | Date Created: 20260827 Date Completed: 20260827 Latest Revision: 20260910 |
| Update Code: | 20260911 |
| PubMed Central ID: | PMC13511456 |
| DOI: | 10.2147/CIA.S609412 |
| PMID: | 42657411 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1178-1998 |
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| DOI: | 10.2147/CIA.S609412 |