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

In brief

Ciprofol shortened anesthesia induction by 8 seconds and reduced injection pain

In a randomized trial of 120 adults having thoracoscopic surgery, ciprofol induction took 38 seconds versus 46 with propofol, and injection pain occurred in 5% versus 20%. Recovery-room stays were also about 8 minutes shorter, while adverse events and emergence time did not differ. The trial found transient differences in blood pressure and early anesthesia-depth readings; larger studies are needed to confirm these benefits.

Journal
Frontiers in medicine (Q1)
Published
1 October 2026
Study design
Randomized controlled trial
Evidence level
Level 1, High (CEBM 1b)
Authors
Yu Wang, Yizhi Geng, Yaodong Yan, Xinying Gao, Qi Shi
PMID
42889180
DOI
10.3389/fmed.2026.1923698

Why clinicians should know about it

Abstract

BACKGROUND: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/showproj.html?proj=203394, Identifier: ChiCTR2400082924.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.