Propofol vs. Ciprofol for Anesthesia Induction in Frail Elderly Patients

June 17, 2026 updated by: General Hospital of Ningxia Medical University

Comparison of the Effects of Propofol and Ciprofol on the Incidence of Post-induction Hypotension in Frail Elderly Patients Undergoing General Anesthesia

Post-induction hypotension (PIH) is a common and critical complication during general anesthesia, particularly in frail elderly patients whose physiological reserves are significantly diminished. PIH is strongly associated with adverse postoperative outcomes, including acute kidney injury (AKI) and myocardial injury. Propofol is the most widely used induction agent but frequently induces circulatory depression. Ciprofol, a novel anesthetic agent developed by optimizing the molecular structure of propofol, has demonstrated improved hemodynamic stability and fewer adverse effects in general populations. However, its specific impact on frail elderly patients remains unestablished.

The primary purpose of this single-center, randomized, double-blind, controlled trial is to compare the effects of propofol and ciprofol during anesthesia induction on the incidence of PIH in frail elderly patients undergoing major abdominal surgery. The investigator's hypothesis is that ciprofol will significantly lower the incidence of PIH compared to propofol. Additionally, the study will evaluate secondary clinical outcomes, such as postoperative AKI, postoperative cardiac complications, and the overall quality of recovery, to provide an evidence-based clinical guide for selecting optimal induction agents for this vulnerable patient population.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Background and Rationale:

Frail elderly patients exhibit an accumulation of multi-system physiological decline, making them highly vulnerable to surgical and anesthetic stressors. During the induction of general anesthesia, these patients are at an exceptionally high risk for severe and prolonged hypotension due to reduced cardiac stroke volume, impaired autonomic nervous system regulation, and altered pharmacokinetics. Post-induction hypotension (PIH)-occurring from the initiation of anesthesia to 10 minutes post-intubation-is directly influenced by the choice of induction agent and the patient's baseline condition, with fewer confounding factors than intraoperative hypotension.

While propofol is highly efficient, its prominent side effect is cardiovascular depression. Ciprofol is an innovative 2,6-disubstituted phenol derivative that maintains the rapid onset and recovery advantages of propofol while offering enhanced hemodynamic stability. To date, clinical evidence comparing these two agents specifically in the frail elderly population is lacking. This study seeks to evaluate whether ciprofol can mitigate the risk of PIH in frail elderly patients undergoing major abdominal surgery and to observe its downstream impacts on major organ protection and postoperative recovery quality.

Study Workflow and Anesthesia Management:

  1. Patient Screening: Patients aged 60 or older with a frailty score >= 3 undergoing major abdominal surgery under general anesthesia with planned invasive blood pressure monitoring will be screened on the day before surgery.
  2. Randomization and Blinding: Eligible participants will be randomized in a 1:1 ratio to either the Propofol Group or the Ciprofol Group. Both patients and outcome assessors will be blinded to the group allocation.

  3. Intervention:

    • Propofol Group: Anesthesia induction will be performed using midazolam, sufentanil, propofol, and rocuronium.
    • Ciprofol Group: Anesthesia induction will be performed using midazolam, sufentanil, ciprofol, and rocuronium.
  4. Monitoring and Follow-up: Standardized intraoperative and perioperative management will be applied uniformly across both groups. Hemodynamic parameters will be monitored continuously. Postoperatively, patients will be followed up to evaluate acute kidney injury (AKI) within 48 hours, cardiac complications (including MINS, congestive heart failure, and acute myocardial infarction) within 7 days or during hospitalization, and overall recovery quality metrics (including mechanical ventilation time, PACU and ICU stay duration, and total postoperative hospital stay).

Study Type

Interventional

Enrollment (Estimated)

96

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • China
    • Ningxia
      • Yinchuan, Ningxia, China, 750000
        • General Hospital of Ningxia Medical University
        • Contact:
          • General Hospital of Ningxia Medical University
          • Phone Number: +86-0951-4091488
          • Email: 13909713260@139.com

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients scheduled to undergo major abdominal surgery under general anesthesia.
  • Frailty score >= 3[cite: 2].
  • Age >= 60 years[cite: 2].
  • American Society of Anesthesiologists (ASA) physical status class >= II[cite: 2].
  • Planned invasive blood pressure monitoring[cite: 2].

Exclusion Criteria:

  • Severe cardiac arrhythmia[cite: 2].
  • Severe valvular heart disease[cite: 2].
  • Poorly controlled hypertension with medication (systolic blood pressure >= 180 mmHg and/or diastolic blood pressure >= 110 mmHg)[cite: 2].
  • Pre-existing preoperative hypotension (mean arterial pressure < 65 mmHg)[cite: 2].
  • Preoperative renal dysfunction (serum creatinine greater than the upper limit of normal)[cite: 2].

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Ciprofol
Frail elderly patients undergoing major abdominal surgery who receive ciprofol for general anesthesia induction, combined with midazolam, sufentanil, and rocuronium.
Drug: Ciprofol
An innovative 2,6-disubstituted phenol derivative used for general anesthesia induction.
Active Comparator: Propofol Group
Frail elderly patients undergoing major abdominal surgery who receive propofol for general anesthesia induction, combined with midazolam, sufentanil, and rocuronium.
Drug: Propofol
An alkylphenol derivative and standard intravenous anesthetic agent used for general anesthesia induction.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence of post-induction hypotension (PIH)
Time Frame: From the initiation of general anesthesia drug administration until 10 minutes after endotracheal intubation.
Post-induction hypotension (PIH) is defined as a mean arterial pressure (MAP) < 65 mmHg lasting for more than 1 minute.
From the initiation of general anesthesia drug administration until 10 minutes after endotracheal intubation.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

General Hospital of Ningxia Medical University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 25, 2026

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

January 31, 2027

Study Registration Dates

First Submitted

June 17, 2026

First Submitted That Met QC Criteria

June 17, 2026

First Posted (Actual)

June 23, 2026

Study Record Updates

Last Update Posted (Actual)

June 23, 2026

Last Update Submitted That Met QC Criteria

June 17, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Hongmei Ma

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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