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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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Τίτλος: Post-Intubation Hypotension After Titrated Induction with Ciprofol versus Propofol in Older Adults Undergoing Non-Cardiac Surgery: A Randomized Controlled Trial.
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
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  Data: 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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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Bai+H%22&quot;&gt;Bai H&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Guo+J%22&quot;&gt;Guo J&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Li+Y%22&quot;&gt;Li Y&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Zhang+S%22&quot;&gt;Zhang S&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Chen+S%22&quot;&gt;Chen S&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Wang+Z%22&quot;&gt;Wang Z&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Lu+K%22&quot;&gt;Lu K&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Zhang+L%22&quot;&gt;Zhang L&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Zhong+F%22&quot;&gt;Zhong F&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Gong+R%22&quot;&gt;Gong R&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Li+J%22&quot;&gt;Li J&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Han+J%22&quot;&gt;Han J&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Song+X%22&quot;&gt;Song X&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Jin+S%22&quot;&gt;Jin S&lt;/searchLink&gt;; Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22101273480%22&quot;&gt;Clinical interventions in aging&lt;/searchLink&gt; [Clin Interv Aging] 2026 Aug 22; Vol. 21, pp. 609412. &lt;i&gt;Date of Electronic Publication: &lt;/i&gt;2026 Aug 22 (&lt;i&gt;Print Publication: &lt;/i&gt;2026).
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  Data: Journal Article; Randomized Controlled Trial; Comparative Study
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  Data: &lt;i&gt;Original Publication&lt;/i&gt;: Auckland : Dove Medical Press
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  Data: &lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Propofol%22&quot;&gt;Propofol*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Propofol+adverse+effects%22&quot;&gt;adverse effects&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Propofol%22&quot;&gt;Propofol*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Propofol+administration+%26+dosage%22&quot;&gt;administration &amp; dosage&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Hypotension%22&quot;&gt;Hypotension*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Hypotension+chemically+induced%22&quot;&gt;chemically induced&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Hypotension%22&quot;&gt;Hypotension*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Hypotension+etiology%22&quot;&gt;etiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anesthetics%2C+Intravenous%22&quot;&gt;Anesthetics, Intravenous*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anesthetics%2C+Intravenous+adverse+effects%22&quot;&gt;adverse effects&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anesthetics%2C+Intravenous%22&quot;&gt;Anesthetics, Intravenous*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Anesthetics%2C+Intravenous+administration+%26+dosage%22&quot;&gt;administration &amp; dosage&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Intubation%2C+Intratracheal%22&quot;&gt;Intubation, Intratracheal*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Intubation%2C+Intratracheal+adverse+effects%22&quot;&gt;adverse effects&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Norepinephrine%22&quot;&gt;Norepinephrine&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Norepinephrine+administration+%26+dosage%22&quot;&gt;administration &amp; dosage&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Humans%22&quot;&gt;Humans&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Aged%22&quot;&gt;Aged&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Female%22&quot;&gt;Female&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Double-Blind+Method%22&quot;&gt;Double-Blind Method&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Male%22&quot;&gt;Male&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Prospective+Studies%22&quot;&gt;Prospective Studies&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Aged%2C+80+and+over%22&quot;&gt;Aged, 80 and over&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Geriatric+Anesthesia%22&quot;&gt;Geriatric Anesthesia&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Cyclopropanes%22&quot;&gt;Cyclopropanes&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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.&lt;br /&gt;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.&lt;br /&gt;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 &amp;lt; 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] &#181;g vs 10.0 [0.0-20.0] &#181;g; P &amp;lt; 0.001), and milder early cardiac output decline (group-by-time interaction β = -0.008, 95% CI -0.010 to -0.005; P &amp;lt; 0.001). No significant between-group differences were observed in early postoperative adverse outcomes.&lt;br /&gt;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.&lt;br /&gt; (&#169; 2026 Bai et al.)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: 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.
– Name: Ref
  Label: References
  Group: RefInfo
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– Name: SubjectMinor
  Label: Contributed Indexing
  Group:
  Data: &lt;i&gt;Keywords: &lt;/i&gt;ciprofol; older adults; post-intubation hypotension; propofol; titration-to-effect
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  Data: YI7VU623SF (Propofol)&lt;br /&gt;0 (Anesthetics, Intravenous)&lt;br /&gt;X4W3ENH1CV (Norepinephrine)&lt;br /&gt;0 ((2-(1R)-1-cyclopropyl)ethyl-6-isopropyl-phenol)&lt;br /&gt;0 (Cyclopropanes)
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  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260827 &lt;i&gt;Date Completed: &lt;/i&gt;20260827 &lt;i&gt;Latest Revision: &lt;/i&gt;20260910
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  Data: 20260911
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  Data: 10.2147/CIA.S609412
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        Value: 10.2147/CIA.S609412
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      – Code: eng
        Text: English
    PhysicalDescription:
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        StartPage: 609412
    Subjects:
      – SubjectFull: Norepinephrine administration & dosage
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Aged
        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Double-Blind Method
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Prospective Studies
        Type: general
      – SubjectFull: Aged, 80 and over
        Type: general
      – SubjectFull: Geriatric Anesthesia
        Type: general
      – SubjectFull: Cyclopropanes
        Type: general
      – SubjectFull: Propofol adverse effects
        Type: general
      – SubjectFull: Propofol administration & dosage
        Type: general
      – SubjectFull: Hypotension chemically induced
        Type: general
      – SubjectFull: Hypotension etiology
        Type: general
      – SubjectFull: Anesthetics, Intravenous adverse effects
        Type: general
      – SubjectFull: Anesthetics, Intravenous administration & dosage
        Type: general
      – SubjectFull: Intubation, Intratracheal adverse effects
        Type: general
    Titles:
      – TitleFull: 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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            – D: 22
              M: 08
              Text: 2026 Aug 22
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1178-1998
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              Value: 21
          Titles:
            – TitleFull: Clinical interventions in aging
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