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August 24, 2026Clinical Interventions in AgingOpen Access

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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Why the study?

To compare ciprofol with propofol for titrated induction of anesthesia in older adults undergoing non-cardiac surgery, focusing on post-intubation hypotension and hemodynamic burden.

Does ciprofol reduce post-intubation hypotension compared to propofol in older adults undergoing non-cardiac surgery?

Population

160 adults aged 65–89 years undergoing elective non-cardiac surgery

Comparison

Ciprofol vs propofol for titrated induction of anesthesia

Design

Single-center prospective randomized double-blind trial

Key result

Ciprofol-based titrated induction significantly reduced the incidence of post-intubation hypotension compared to propofol (36.3% vs 67.0%; adjusted OR 0.28) in older adults undergoing non-cardiac surgery.

Authors

HBHong BaiJGJing GuoYLYumei Li

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Overview

Ciprofol reduces post-intubation hypotension incidence and burden versus propofol in older adults; extends hemodynamic stability data for titrated induction in geriatric noncardiac surgery.

Key Points

  • To compare the incidence of post-intubation hypotension and hemodynamic stability between ciprofol and propofol during titrated anesthesia induction in older adults undergoing elective non-cardiac surgery.
  • Prospective, randomized, double-blind trial enrolling 160 adults aged 65–89 years undergoing elective non-cardiac surgery.
  • Participants were randomly assigned (1:1) to receive either ciprofol or propofol using an identical titration-to-effect induction protocol.
  • The primary outcome was post-intubation hypotension, defined as mean arterial pressure ≤ 65 mmHg within 15 minutes after intubation and prior to surgical incision.
  • Post-intubation hypotension occurred significantly less often with ciprofol than with propofol (28/77 [36.3%] vs 53/79 [67.0%]; adjusted OR 0.28, 95% CI 0.15–0.54; P < 0.001).
  • Ciprofol led to a lower hypotensive burden (AUC 0.0 vs 2.5 mmHg·min; P = 0.047) and reduced rescue norepinephrine requirements (0.0 μg vs 10.0 μg; P < 0.001).
  • Early cardiac output decline was milder with ciprofol (group-by-time interaction β = −0.008, 95% CI −0.010 to −0.005; P < 0.001), with no significant differences in early postoperative adverse outcomes.

Study Design

Type

RCT (n=160)

Blinding

Double-blind

Randomization

1:1 ratio, fixed block size of 10, stratified by ASA physical status

Multicenter

No

Structured PICO

Does ciprofol reduce post-intubation hypotension compared to propofol in older adults undergoing non-cardiac surgery?

P
Population
160 older adults aged 65-89 years with ASA physical status I-III undergoing elective non-cardiac surgery, evaluated during anesthesia induction and the immediate post-intubation period.
I
Intervention
Ciprofol following a titration-to-effect induction protocol
C
Comparator
Propofol following an identical titration-to-effect induction protocol
O
Outcome
Post-intubation hypotension, defined as any mean arterial pressure (MAP) <= 65 mmHg during the 15-minute period after successful tracheal intubation and before surgical incisionsafety

Main Result

Odds Ratio: 0.28 (95% CI 0.15–0.54)

Absolute Event Rate: 36.3% vs 67%

p-value: p=<0.001

Ciprofol-based titrated induction significantly reduces post-intubation hypotension and vasopressor requirements compared to propofol in older adults undergoing non-cardiac surgery.

Limitations

  • Single-center trial design
  • Findings require confirmation in larger multicenter studies
  • Single-center trial
  • Requires confirmation in larger multicenter studies

Cite This Study

Bai et al. (2026) conducted an RCT in Non-cardiac surgery in older adults (n=160). Ciprofol vs. Propofol was evaluated on Post-intubation hypotension (any MAP ≤ 65 mmHg during the 15-minute period after successful tracheal intubation) (adjusted OR 0.28, 95% CI 0.15-0.54, p=<0.001). Ciprofol-based titrated induction significantly reduced the incidence of post-intubation hypotension compared to propofol (36.3% vs 67.0%; adjusted OR 0.28) in older adults undergoing non-cardiac surgery.

synapsesocial.com/papers/6a8c006bfef69d75bf3cb90dhttps://doi.org/10.2147/cia.s609412
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