Efficacy and Safety of Ciprofol Versus Propofol for Anesthesia in Older Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

IF 4.2 3区 医学 Q2 GERIATRICS & GERONTOLOGY
Wenbo Gao, Qinru Yang, Yungong Wang, Hanqi Wang, Ming Yao
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Abstract

Background and objective: Propofol is widely used in clinical anesthesia, but its cardiorespiratory depressive effects may limit its safety in older patients. With the growing number of older adults requiring anesthesia, ciprofol has attracted interest because of its higher potency and relatively mild hemodynamic impact. This meta-analysis evaluated the efficacy and safety of ciprofol compared with propofol in older patients undergoing general anesthesia or painless endoscopy.

Methods: We conducted a comprehensive search of PubMed, Embase, the Cochrane Library, and Web of Science up to 7 November, 2025, to identify eligible studies. All statistical analyses were performed using RevMan 5.4 and R version 4.5.1.

Results: A total of 12 randomized controlled trials involving 2027 older participants were included. For safety outcomes, ciprofol significantly reduced the incidence of hypotension (risk ratio = 0.76, 95% confidence interval 0.68-0.84; p < 0.00001) and injection pain (risk ratio = 0.16, 95% confidence interval 0.09-0.26; p < 0.00001) compared with propofol. No significant differences were observed between the two agents in the incidence of bradycardia, hypoxemia, and postoperative nausea and vomiting. Regarding efficacy outcomes, ciprofol was associated with a longer time to loss of consciousness compared with propofol (mean difference = 4.67 seconds, 95% confidence interval 0.65-8.70; p = 0.02), while no significant differences were observed in anesthesia success rate, procedure completion rate, and awakening time.

Conclusions: Based on the currently available evidence from randomized trials conducted in China, ciprofol showed comparable efficacy to propofol and was associated with lower incidences of hypotension and injection pain in older patients. These findings may still be informative for anesthetic management in broader settings, although further validation is needed.

Clinical trial registration: PROSPERO registration number: CRD420251179366.

环丙酚与异丙酚在老年患者麻醉中的疗效和安全性:随机对照试验的系统评价和荟萃分析。
背景与目的:异丙酚被广泛应用于临床麻醉,但其抑制心肺功能的作用可能限制其在老年患者中的安全性。随着越来越多的老年人需要麻醉,环丙酚因其更高的效力和相对轻微的血流动力学影响而引起了人们的兴趣。本荟萃分析评估了环丙酚与异丙酚在接受全身麻醉或无痛内窥镜检查的老年患者中的疗效和安全性。方法:我们对PubMed、Embase、Cochrane图书馆和Web of Science进行了全面检索,检索截止到2025年11月7日,以确定符合条件的研究。采用RevMan 5.4和R 4.5.1进行统计分析。结果:共纳入12项随机对照试验,涉及2027名老年受试者。安全性方面,环丙酚显著降低低血压的发生率(风险比= 0.76,95%可信区间0.68-0.84;p)结论:根据目前在中国进行的随机试验的证据,环丙酚的疗效与异丙酚相当,并且与老年患者低血压和注射疼痛的发生率较低相关。尽管需要进一步验证,但这些发现仍可为更广泛的麻醉管理提供信息。临床试验注册:PROSPERO注册号:CRD420251179366。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Drugs & Aging
Drugs & Aging 医学-老年医学
CiteScore
5.50
自引率
7.10%
发文量
68
审稿时长
6-12 weeks
期刊介绍: Drugs & Aging delivers essential information on the most important aspects of drug therapy to professionals involved in the care of the elderly. The journal addresses in a timely way the major issues relating to drug therapy in older adults including: the management of specific diseases, particularly those associated with aging, age-related physiological changes impacting drug therapy, drug utilization and prescribing in the elderly, polypharmacy and drug interactions.
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