{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T11:00:39Z","timestamp":1771930839682,"version":"3.50.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"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>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Post-induction hypotension (PIH) represents a frequent perioperative complication among elderly patients, and its prevention is critical for reducing organ damage and postoperative adverse outcomes. This study aims to evaluate the impact of ciprofol on the incidence of PIH when used for general anesthesia induction in elderly patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was carried out on the clinical records of elderly patients who underwent elective total hip replacement surgery at our hospital between August 2024 and July 2025. Patients were stratified into the ciprofol group and the propofol group based on the anesthetic sedative agents administered. The primary outcome indicator was PIH, characterized as a mean arterial pressure (MAP) \u226465\u202fmmHg or a reduction greater than 30% relative to baseline values within 20\u202fmin post-induction. Subgroup analyses included considerations of preoperative hypertension, the Clinical Frailty Scale (CFS), the age-adjusted Charlson Comorbidity Index (aCCI), and patient age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline clinical features were comparable across groups. The incidence of PIH was markedly lower in the ciprofol group than in the propofol group (36.4% vs. 65.5%; absolute risk reduction\u202f=\u202f29.1, 95% confidence interval: 11.2\u201347.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002). Subgroup analyses demonstrated that the advantages of ciprofol remained consistent across all pre-specified subgroups, with prominent differences noted in patients aged under 90\u202fyears, those with an aCCI of \u22644, a CFS score of \u22644, and baseline blood pressure (BP) of &amp;lt;140\/90\u202fmmHg.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ciprofol reduces PIH risk, improves haemodynamic stability, and decreases vasoactive agent use and injection pain compared with propofol in elderly patients, independent of baseline characteristics, indicating suitability for anesthetic management in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1764580","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T07:36:16Z","timestamp":1770622576000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of ciprofol on the incidence of hypotension during induction of general anesthesia in elderly patients undergoing total hip arthroplasty: single-center retrospective study"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiaxi","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, General Hospital of Southern Theater Command","place":["Guangzhou, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, General Hospital of Southern Theater Command","place":["Guangzhou, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, General Hospital of Southern Theater Command","place":["Guangzhou, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yicai","family":"Gan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, General Hospital of Southern Theater Command","place":["Guangzhou, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, General Hospital of Southern Theater Command","place":["Guangzhou, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, General Hospital of Southern Theater Command","place":["Guangzhou, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1093\/bja\/aex127","article-title":"Post-induction hypotension and early intraoperative hypotension associated with general anaesthesia","volume":"119","author":"S\u00fcdfeld","year":"2017","journal-title":"Br J Anaesth"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1007\/s00540-023-03191-7","article-title":"Post-induction hypotension and intraoperative hypotension as potential separate risk factors for the adverse outcome: a cohort study","volume":"37","author":"Czajka","year":"2023","journal-title":"J Anesth"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1016\/j.bja.2020.05.048","article-title":"Intraoperative hypotension is just the tip of the iceberg: a call for multimodal, individualised, contextualised management of intraoperative cardiovascular dynamics","volume":"125","author":"Molnar","year":"2020","journal-title":"Br J Anaesth"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1654","DOI":"10.1213\/ANE.0000000000005250","article-title":"Intraoperative hypotension is associated with adverse clinical outcomes after noncardiac surgery","volume":"132","author":"Gregory","year":"2021","journal-title":"Anesth Analg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e074181","DOI":"10.1136\/bmjopen-2023-074181","article-title":"Protocol for development and validation of a prediction model for post-induction hypotension in elderly patients undergoing non-cardiac surgery: a prospective cohort study","volume":"13","author":"Hu","year":"2023","journal-title":"BMJ Open"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.cell.2018.08.031","article-title":"Propofol: milk of amnesia","volume":"175","author":"Walsh","year":"2018","journal-title":"Cell"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"d1110","DOI":"10.1136\/bmj.d1110","article-title":"Prevention of pain on injection of propofol: systematic review and meta-analysis","volume":"342","author":"Jalota","year":"2011","journal-title":"BMJ"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"3639","DOI":"10.2174\/1381612043382846","article-title":"Propofol: therapeutic indications and side-effects","volume":"10","author":"Marik","year":"2004","journal-title":"Curr Pharm Des"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1213\/01.ANE.0000087043.61777.1F","article-title":"The 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baseline or absolute thresholds, and acute kidney and myocardial injury after noncardiac surgery: a retrospective cohort analysis","volume":"126","author":"Salmasi","year":"2017","journal-title":"Anesthesiology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1016\/j.bja.2019.01.013","article-title":"Perioperative quality initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery","volume":"122","author":"Sessler","year":"2019","journal-title":"Br J Anaesth"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.bja.2024.04.013","article-title":"Hypotension after general anaesthesia induction using remimazolam or propofol in geriatric patients undergoing sevoflurane anaesthesia with remifentanil: a single-centre, double-blind, randomised controlled trial","volume":"133","author":"Takaki","year":"2024","journal-title":"Br J Anaesth"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"8580","DOI":"10.1021\/acs.jmedchem.7b01133","article-title":"Oral delivery of propofol with methoxymethylphosphonic acid as the delivery vehicle","volume":"60","author":"Wei","year":"2017","journal-title":"J Med Chem"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1001\/jama.2013.278477","article-title":"Effect of heart rate control with esmolol on hemodynamic and clinical outcomes in patients with septic shock: a randomized clinical trial","volume":"310","author":"Morelli","year":"2013","journal-title":"JAMA"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"5063","DOI":"10.26355\/eurrev_202207_29292","article-title":"Effect of ciprofol on induction and maintenance of general anesthesia in patients undergoing kidney transplantation","volume":"26","author":"Qin","year":"2022","journal-title":"Eur Rev Med Pharmacol 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