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Ciprofol vs. propofol in thoracoscopic surgery: Quality of recovery and cerebral oxygen saturation

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Created On: 18/09/2026

Propofol remains the standard intravenous hypnotic agent used for general anesthesia.

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Key take away

Ciprofol matches propofol in postoperative recovery quality while markedly reducing injection pain, decreasing vasopressor dependence, and improving intraoperative cerebral oxygen saturation during thoracoscopic thoracic surgery.

Background

Propofol remains the standard intravenous hypnotic agent used for general anesthesia. However, its administration is frequently complicated by injection-site pain, cardiorespiratory depression, and hemodynamic instability. Ciprofol, a gamma-aminobutyric acid type A (GABAA) receptor agonist, exhibits higher potency and a favorable safety profile.

One-lung ventilation during video-assisted thoracoscopic surgery (VATS) creates significant physiological stress that can hamper regional cerebral oxygen saturation (rScO2 ) and compromise early postoperative recovery. Researchers compared ciprofol with propofol to determine whether it offers comparable postoperative recovery, with additional assessment of cerebral oxygenation and haemodynamic stability during surgery.

Method

This prospective, randomized clinical trial enrolled 94 patients undergoing elective thoracoscopic thoracic surgery. Volunteers were randomly allocated in a 1:1 ratio to receive either ciprofol (Group C) or propofol (Group P) for induction and maintenance of anesthesia. Of the 94 randomized patients, 88 completed the study, with 44 in each group.

Primary endpoint: Global 15-item Quality of Recovery (QoR-15) score evaluated at 24 hours post-operatively, using a predefined non-inferiority margin of -6.0.
Secondary endpoints: Global QoR-15 score at 48 hours post-operatively, incidence of injection-site pain, vasoactive drug requirements (phenylephrine), mean arterial pressure (MAP), heart rate, and continuous monitoring of intraoperative rScO2.
Analysis protocols: Both intent-to-treat (ITT) and per-protocol (PP) analyses were executed to assess non-inferiority.

Result

Postoperative recovery: At 24 hours, the mean QoR-15 score with ciprofol was non-inferior to propofol in the ITT analysis. The PP analysis produced consistent findings.
48-hour recovery: Ciprofol also exhibited non-inferiority to propofol at 48 hours.
Injection pain: Ciprofol substantially reduced injection pain compared with propofol (4.5% vs 59%).
Vasopressor use: Patients receiving ciprofol required less phenylephrine, with the between-group difference reaching statistical significance.
Heart rate: Propofol was associated with a higher heart rate after induction compared with ciprofol.
MAP: It was lower in the propofol group after induction.
Cerebral oxygenation: rScO2 was markedly higher with ciprofol after induction and remained higher during the anaesthesia maintenance phase.

Conclusion

Ciprofol proved non-inferior to propofol in preserving early postoperative recovery quality in patients undergoing thoracoscopic thoracic surgery. Beyond achieving equivalent recovery scores, ciprofol offered distinct clinical advantages: it mitigated injection-site pain, preserved MAP, lowered reliance on vasoconstrictor therapy, and better maintained rScO2 during procedure-linked single-lung ventilation.

Source:

Drug Design, Development and Therapy

Link:

https://www.dovepress.com/comparison-of-ciprofol-and-propofol-on-postoperative-quality-of-recove-peer-reviewed-fulltext-article-DDDT

Article:

Comparison of Ciprofol and Propofol on Postoperative Quality of Recovery and Intraoperative Cerebral Oxygen Saturation in Patients Undergoing Thoracoscopic Thoracic Surgery: A Randomized, Double-Blind, Non-Inferiority Trial