{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T07:02:50Z","timestamp":1776841370440,"version":"3.51.2"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to compare the effects of ciprofol and propofol on mean arterial pressure (MAP) management, vasoactive drug usage, and postoperative complications after carotid endarterectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 103 patients were included in either the ciprofol (<jats:italic>n<\/jats:italic>\u202f=\u202f50) or propofol (<jats:italic>n<\/jats:italic>\u202f=\u202f53) group. The MAP was recorded at nine perioperative timepoints from before anesthesia (T0) to extubation (T8). We focused on the achievement rate of the target MAP during carotid cross-clamping at T4\u2013T6. We also examined vasopressor use (norepinephrine, urapidil) and postoperative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In terms of primary outcomes, the ciprofol group exhibited a higher MAP at T3 (before the skin incision; <jats:italic>p<\/jats:italic>\u202f=\u202f0.006) and achieved the target MAP faster at T4\u2013T5 (during carotid cross-clamping and 5\u202fmin after cross-clamping; <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001) than did the propofol group. There were no statistically significant differences between the groups at T6 (10\u202fmin after cross-clamping; <jats:italic>p<\/jats:italic>\u202f=\u202f0.360). The ciprofol group exhibited significantly better hemodynamic stability during extubation (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). Regarding the secondary outcomes, the ciprofol group was administered a lower dosage of norepinephrine (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001) and had fewer cases of early cognitive dysfunction (eCD) (<jats:italic>p<\/jats:italic>\u202f=\u202f0.024).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These findings suggest that ciprofol offers advantages over propofol during carotid endarterectomy by optimizing MAP control, minimizing vasopressor use, and mitigating postoperative complications. Ciprofol may be the preferable anesthetic agent in carotid artery-related procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:uri>https:\/\/www.chictr.org.cn\/<\/jats:uri>, identifier ChiCTR2500104162.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1648417","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T05:30:46Z","timestamp":1760679046000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative study of ciprofol vs. propofol in carotid endarterectomy: focusing on mean arterial pressure, vasoactive drug use, and postoperative complications"],"prefix":"10.3389","volume":"12","author":[{"given":"Xinxin","family":"Zheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiyun","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Tian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanqing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Bai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e721","DOI":"10.1016\/S2214-109X(20)30117-0","article-title":"Global and regional prevalence, burden, and risk factors for carotid atherosclerosis: a systematic review, meta-analysis, and modelling study","volume":"8","author":"Song","year":"2020","journal-title":"Lancet Glob Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1074","DOI":"10.1016\/S0140-6736(10)61197-X","article-title":"10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial","volume":"376","author":"Halliday","year":"2010","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"znae227","DOI":"10.1093\/bjs\/znae227","article-title":"Identification of patient characteristics that may improve procedure selection for the treatment of carotid stenosis","volume":"111","author":"Kuehnl","year":"2024","journal-title":"Br J Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1227\/NEU.0000000000000256","article-title":"Arterial blood pressure management during carotid endarterectomy and early cognitive dysfunction","volume":"74","author":"Heyer","year":"2014","journal-title":"Neurosurgery"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1111\/bcp.13441","article-title":"Quantitative analysis of the effect of end\u2010tidal carbon dioxide on regional cerebral oxygen saturation in patients undergoing carotid endarterectomy under general anaesthesia","volume":"84","author":"Ki","year":"2018","journal-title":"Br J Clin Pharmacol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1016\/S1474-4422(22)00290-3","article-title":"Carotid endarterectomy or stenting or best medical treatment alone for moderate-to-severe asymptomatic carotid artery stenosis: 5-year results of a multicentre, randomised controlled trial","volume":"21","author":"Reiff","year":"2022","journal-title":"Lancet Neurol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4885","DOI":"10.3390\/jcm12154885","article-title":"Near-infrared spectroscopy-guided, individualized arterial blood pressure management for carotid endarterectomy under general anesthesia: a randomized, controlled trial","volume":"12","author":"Tomic Mahecic","year":"2023","journal-title":"J Clin Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1016\/j.jvs.2021.08.070","article-title":"Intraoperative blood pressure lability carries a higher risk of headache after carotid endarterectomy","volume":"75","author":"Lee","year":"2022","journal-title":"J Vasc Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1007\/s10877-021-00653-9","article-title":"Mechanisms contributing to hypotension after anesthetic induction with sufentanil, propofol, and rocuronium: a prospective observational study","volume":"36","author":"Saugel","year":"2022","journal-title":"J Clin Monit Comput"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1007\/s11096-022-01529-x","article-title":"Efficacy and safety of ciprofol versus propofol for the induction of anesthesia in adult patients: a multicenter phase 2a clinical trial","volume":"45","author":"Zhu","year":"2023","journal-title":"Int J Clin Pharm"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1007\/s40263-021-00890-1","article-title":"Efficacy and safety of HSK3486 for anesthesia\/sedation in patients undergoing fiberoptic bronchoscopy: a multicenter, double-blind, propofol-controlled, randomized, phase 3 study","volume":"36","author":"Luo","year":"2022","journal-title":"CNS Drugs"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"111047","DOI":"10.1016\/j.jclinane.2022.111047","article-title":"Efficacy and safety of ciprofol for procedural sedation and anesthesia in non-operating room settings","volume":"85","author":"Zhong","year":"2023","journal-title":"J Clin Anesth"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1111\/anae.16456","article-title":"Safety of anaesthesia techniques in patients undergoing carotid endarterectomy: a systematic review with meta-analysis of randomised clinical trials","volume":"80","author":"de Carvalho","year":"2025","journal-title":"Anaesthesia"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1016\/j.ejvs.2023.02.079","article-title":"Long term mortality rate in patients treated with carotid endarterectomy","volume":"65","author":"Waden","year":"2023","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e18631","DOI":"10.7759\/cureus.18631","article-title":"Comparison of postoperative cognitive decline using the mini-mental state examination and Montreal cognitive assessment after minor elective surgery in elderly","volume":"13","author":"Ayta\u00e7","year":"2021","journal-title":"Cureus"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"684307","DOI":"10.3389\/fpsyg.2021.684307","article-title":"Neuropsychological tests in post-operative cognitive dysfunction: methods and applications","volume":"12","author":"Liu","year":"2021","journal-title":"Front Psychol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1972","DOI":"10.1111\/cts.13605","article-title":"Drug-drug interaction study of ciprofol and sodium divalproex: pharmacokinetics, pharmacodynamics, and safety in healthy Chinese subjects","volume":"16","author":"Yang","year":"2023","journal-title":"Clin Transl Sci"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"830791","DOI":"10.3389\/fphar.2022.830791","article-title":"Pharmacodynamics and pharmacokinetics of HSK3486, a novel 2,6-Disubstituted phenol derivative as a general anesthetic","volume":"13","author":"Liao","year":"2022","journal-title":"Front Pharmacol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1111\/bcp.14363","article-title":"Mass balance, pharmacokinetics and pharmacodynamics of intravenous HSK3486, a novel anaesthetic, administered to healthy subjects","volume":"87","author":"Bian","year":"2021","journal-title":"Br J Clin Pharmacol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"4179","DOI":"10.1039\/d3ay01168b","article-title":"Calibration and validation of ultraviolet time-of-flight mass spectrometry for online measurement of exhaled ciprofol","volume":"15","author":"Li","year":"2023","journal-title":"Anal Methods"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1097\/EJA.0000000000001799","article-title":"Efficacy and safety of ciprofol vs. propofol for the induction and maintenance of general anaesthesia: a multicentre, single-blind, randomised, parallel-group, phase 3 clinical trial","volume":"40","author":"Liang","year":"2023","journal-title":"Eur J Anaesthesiol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1225288","DOI":"10.3389\/fphar.2023.1225288","article-title":"A systematic review and meta-analysis comparing the efficacy and safety of ciprofol (HSK3486) versus propofol for anesthetic induction and non-ICU sedation","volume":"14","author":"Hung","year":"2023","journal-title":"Front Pharmacol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1001\/jamasurg.2025.1299","article-title":"Hemodynamic impact of cipepofol vs propofol during anesthesia induction in patients with severe aortic stenosis: a randomized clinical trial","volume":"160","author":"Ni","year":"2025","journal-title":"JAMA Surg"},{"key":"ref24","volume-title":"Carotid sinus hypersensitivity","author":"Kharsa","year":"2025"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.avsg.2021.06.015","article-title":"Variation in perioperative cerebral and hemodynamic monitoring during carotid endarterectomy","volume":"77","author":"Fassaert","year":"2021","journal-title":"Ann Vasc Surg"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.anclin.2020.11.006","article-title":"Anesthesia for carotid endarterectomy, angioplasty, and stent","volume":"39","author":"Nelson","year":"2021","journal-title":"Anesthesiol Clin"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.avsg.2021.06.044","article-title":"Intraoperative cerebral monitoring during carotid surgery: a narrative review","volume":"78","author":"Bozzani","year":"2022","journal-title":"Ann Vasc Surg"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"3088","DOI":"10.1161\/STROKEAHA.107.511360","article-title":"Intraoperative microemboli and low middle cerebral artery blood flow velocity are additive in predicting development of cerebral ischemic events after carotid endarterectomy","volume":"39","author":"Ogasawara","year":"2008","journal-title":"Stroke"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1097\/MCC.0000000000000912","article-title":"The intensive care management of acute ischaemic stroke","volume":"28","author":"Sharma","year":"2022","journal-title":"Curr Opin Crit Care"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"13","DOI":"10.48729\/pjctvs.502","article-title":"Hemodynamic predictors and changes during carotid endarterectomy under regional anesthesia","volume":"32","author":"Silva","year":"2025","journal-title":"Port J Card Thorac Vasc Surg"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/j.jvs.2021.08.074","article-title":"Headache prevention after carotid endarterectomy to mitigate risk of cerebral hyperperfusion syndrome","volume":"75","author":"Pillai","year":"2022","journal-title":"J Vasc Surg"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1708","DOI":"10.1161\/CIRCULATIONAHA.105.602532","article-title":"Endothelial nitric oxide synthase in vascular disease: from marvel to menace","volume":"113","author":"Forstermann","year":"2006","journal-title":"Circulation"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1186\/s12871-023-02342-3","article-title":"Micro- and macrocirculatory effects of norepinephrine on anaesthesia-induced hypotension: a prospective preliminary study","volume":"23","author":"Kindermans","year":"2023","journal-title":"BMC Anesthesiol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1007\/s12028-022-01484-5","article-title":"Impact of cerebral autoregulation monitoring in cerebrovascular disease: a systematic review","volume":"36","author":"Al-Kawaz","year":"2022","journal-title":"Neurocrit Care"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1177\/1060028017694376","article-title":"Impact of norepinephrine weight-based dosing compared with non-weight-based dosing in achieving time to goal mean arterial pressure in obese patients with septic shock","volume":"51","author":"Droege","year":"2017","journal-title":"Ann Pharmacother"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1648417\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T05:30:47Z","timestamp":1760679047000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1648417\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,17]]},"references-count":35,"alternative-id":["10.3389\/fmed.2025.1648417"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1648417","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,17]]},"article-number":"1648417"}}