{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:26:24Z","timestamp":1786112784549,"version":"build-2736575974"},"reference-count":18,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacology"],"abstract":"<jats:p>Introduction: Propofol is the standard agent for anesthesia induction but is frequently associated with injection-site pain and hemodynamic instability. Ciprofol (HSK3486), a novel GABA&lt;sub&gt;A&lt;\/sub&gt; receptor agonist, has emerged as a potential alternative. This study aimed to evaluate the efficacy and safety of ciprofol compared to propofol when induction of general anesthesia in patients undergoing major orthopedic surgery. Methods: In this study, 245 patients (ASA I\u2013II) were allocated into ciprofol (CL, n = 107) or propofol (PL, n = 138) cohorts for major orthopedic surgery. All participants received midazolam (0.03 mg\/kg), sufentanil (0.3 \u03bcg\/kg), and preoxygenation. Induction was initiated with ciprofol (0.4 mg\/kg over 30 s) or propofol (2 mg\/kg). Successful induction required a modified Observer\u2019s Assessment of Alertness\/Sedation (OAA\/S) score \u22641 within 1 min. Persistent sedation failure necessitated a secondary dose (0.2 mg\/kg of in ciprofol in CL cohort; PL: 1 mg\/kg propofol in PL cohort). If failure continued, 0.5 mg\/kg propofol served as rescue sedation for both groups. Post-intubation, anesthesia was maintained via sevoflurane in 50% oxygen. Results: Both cohorts achieved high induction success rates. One-minute post-administration, the median OAA\/S score was 1 for both groups, though the PL cohort exhibited a higher frequency of deep sedation (OAA\/S = 0) compared to the CL cohort (p &lt; 0.001). The median time to successful induction was comparable between CL (49 s) and PL (48 s) (p = 0.136). However, the CL cohort demonstrated significantly greater hemodynamic stability, with a lower incidence of hypotension (9% vs. 28% in PL, p &lt; 0.001). Furthermore, ciprofol significantly reduced injection-site pain, with a median VAS of 4 compared to 5 in the propofol group (p &lt; 0.001), and a lower proportion of patients experiencing moderate-to-severe pain (p = 0.018). Bispectral index changes also favored the CL cohort (49.89 \u00b1 3.15 vs. 40 \u00b1 3.35, p &lt; 0.001). Regarding intubation-related adverse events, the PL cohort experienced significantly higher rates of hypotension (28%) compared to the CL cohort (9%; p &lt; 0.001). Conclusion: Ciprofol is a highly effective alternative to propofol for anesthesia induction in major orthopedic surgery. It provides rapid onset and successful sedation while offering superior clinical advantages, specifically reduced injection-site pain and enhanced hemodynamic stability during the critical induction and intubation phases.<\/jats:p>","DOI":"10.1159\/000552425","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T16:00:41Z","timestamp":1778947241000},"page":"1-11","source":"Crossref","is-referenced-by-count":0,"title":["Ciprofol versus Propofol for General Anesthesia Induction in Major Orthopedic Surgery: Efficacy and Safety Analyses Pertaining to Anesthetic Parameters"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0484-3669","authenticated-orcid":false,"given":"Xia","family":"Yao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6270-5967","authenticated-orcid":false,"given":"Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8604-9293","authenticated-orcid":false,"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4701-0643","authenticated-orcid":false,"given":"Jicheng","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-018-0672-3"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-022-01782-7"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1021\/acs.jmedchem.7b00254"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14363"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/s2222-1808(14)60411-4"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.735700"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-024-02795-0"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-025-03054-6"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-021-01914-4"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v11.i2.90"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000006893"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d1110"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.4103\/aer.aer_93_22"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2022.43.3.20210876"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13085"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeu100"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1111\/evj.70103"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000016873"}],"container-title":["Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000552425","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T16:01:01Z","timestamp":1785945661000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000552425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,16]]},"references-count":18,"URL":"https:\/\/doi.org\/10.1159\/000552425","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32305848","asserted-by":"subject"}]},"ISSN":["0031-7012","1423-0313"],"issn-type":[{"value":"0031-7012","type":"print"},{"value":"1423-0313","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,16]]}}}