Comparative effects of ciprofol and propofol on perioperative hemodynamics during hip arthroplasty in older adults with frailty: A prospective randomized controlled trial

Abstract Background and Aims: The proportion of older adults with frailty undergoing total hip arthroplasty (THA) has increased significantly against the backdrop of the rapidly aging population. However, the benefits of ciprofol in this population have not been widely investigated. Material and Methods: We conducted a single-center, prospective, double-blind, randomized controlled trial. From October 2024 to July 2025, this study was conducted at a large, university-affiliated tertiary care hospital. After obtaining ethical approval, 78 older adults with frailty undergoing hip arthroplasty scheduled for elective laparoscopic surgery were enrolled. Using a randomized numerical table method, they were classified into either the ciprofol group (Group A) or the propofol group (Group B), with 39 patients in each group. Cardiac output (CO) and the mean arterial pressure (MAP) were recorded at eight intraoperative time points from T0 to T7, in addition to the use of intraoperative vasoactive drugs, postoperative awakening time, extubation time, postoperative complications, and length of hospitalization. Results: At T2 (preintubation) and T3 (immediately postintubation), MAP and CO in the ciprofol group were significantly higher than those in the propofol group ( P < 0.05). Furthermore, the use of intraoperative vasoactive drugs was significantly lower in Group A. No significant differences were observed between these groups in postoperative awakening time, extubation time, the length of hospitalization, and complications. Conclusions: Ciprofol shows comparable efficacy as propofol for the induction and maintenance of anesthesia during THA in older adults with frailty. Furthermore, ciprofol yields a better perioperative hemodynamic profile and causes fewer adverse effects.