• Dawei Yang, Jie Zhou, Luyu Sun, Min Li, and Jianyou Zhang.
• Department of Anesthesiology, Affiliated Hospital of Yangzhou University, University of Yangzhou, Yangzhou, China.
• Minerva Anestesiol. 2024 Dec 3.

BackgroundThe aim of this paper was to compare the impact of continuous infusion of ciprofol versus propofol on postoperative awakening in elderly patients following hip replacement surgery.MethodsPatients were randomized into two groups (N.=45 each): the ciprofol group and the propofol group. The ciprofol group received ciprofol for anesthesia induction and maintenance, while the propofol group underwent anesthesia induction and maintenance using propofol. The primary outcome was awakening time. Secondary outcomes included spontaneous breathing recovery time, extubation time, time to modified Aldrete Score ≥9, modified observer's assessment of alertness/sedation (MOAA/S) scores, anesthetic dosage, volume of fluid replacement, urine output and administration of vasoactive drugs.ResultsThe Ciprofol group exhibited a significantly prolonged awakening time (11.0±6.4 min vs. 7.4±4.3 min, P=0.003), spontaneous breathing recovery time (9.9±6.3 min vs. 5.9±4.3 min, P=0.001), and extubation time (12.0 [8.0-16.0] min vs. 8.5 [6.0-11.0] min, P=0.005), and reduced requirement for intraoperative fluid replacement (728.9±254.2 mL vs. 908.3±287.5 mL, P=0.003), increased urine output (235.1±102.1 mL vs. 173.5±106.2 mL, P=0.007), decreased likelihood of vasoactive drug administration (15/30 vs. 28/14, P=0.002). No significant differences were observed between the two groups in terms of reaching a modified Aldrete Score ≥9, MOAA/S scores at 0, 5, 15, or 30 minutes post-extubation, or occurrence of adverse reactions (P>0.05). The dosage of remifentanil was significantly higher in the ciprofol group [5.4 (2.7-7.4) μg·kg-1·h-1 vs. 3.4 (1.9-4.3) μg·kg-1·h-1, P=0.004], with a mean maintenance dose of ciprofol at 0.8 mg·kg-1·h-1 (range: 0.5 to 1.2 mg·kg-1·h-1).ConclusionsCompared to propofol, the administration of ciprofol in elderly patients following hip replacement surgery is associated with prolonged awakening time, spontaneous breathing recovery time, and extubation. The average intravenous maintenance dosage of ciprofol in geriatric patients under general anesthesia was 0.8 mg·kg-1·h-1.

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