{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T06:00:42Z","timestamp":1785477642518,"version":"3.56.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"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. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with elevated body mass index (BMI) are particularly susceptible to propofol-induced hypotension during anesthesia induction. Fospropofol, a water-soluble prodrug of propofol, may confer hemodynamic advantages through gradual release kinetics, yet its profile in high-BMI patients remains incompletely characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This pre-specified secondary analysis of a randomised controlled trial (ChiCTR2500101725) enrolled 120 patients with BMI \u226528\u2005kg\/m\u00b2 scheduled for elective surgery, randomised to fospropofol (FOS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200960) or propofol (PRO,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200960). The primary endpoint of this analysis was hypotension incidence (any MAP &amp;lt;65 mmHg) during the pre-incision phase. Key secondary endpoints included hypotension area under the curve (AUC), MAP variability, emergence time, extubation time, and hospital length of stay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Hypotension incidence was 30.0% (FOS) vs. 71.7% (PRO) [RR 2.39, 95% CI 1.57\u20133.63;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001; NNT 2.4 (i.e., one additional patient needs to be treated with fospropofol rather than propofol to prevent one case of hypotension)]. FOS patients had reduced hypotension burden (median AUC 0.0 vs. 29.5 mmHg\u00b7min;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), lower MAP variability (8.7\u2009\u00b1\u20092.2% vs. 19.0\u2009\u00b1\u20097.4%; Cohen's d\u2009=\u20091.87), and higher MAP nadir (median 69.5 vs. 55.0 mmHg;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Emergence time was shorter with FOS (7.9\u2009\u00b1\u20092.7 vs. 10.7\u2009\u00b1\u20093.4\u2005min; d\u2009=\u20090.91), as was extubation time (10.0\u2009\u00b1\u20092.7 vs. 12.7\u2009\u00b1\u20093.5\u2005min; d\u2009=\u20090.86). A significant treatment\u2009\u00d7\u2009surgery interaction for extubation time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042) indicated amplified benefit in abdominal procedures (\n                      <jats:italic>\u0394<\/jats:italic>\n                      \u2009=\u2009\u22123.58\u2005min vs. \u22121.07\u2005min).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fospropofol demonstrated superior hemodynamic stability during the pre-incision phase and faster early recovery compared with propofol in high-BMI patients, particularly in abdominal surgical procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/showproj.html?proj=253889<\/jats:ext-link>\n                      , identifier ChiCTR2500101725 (registered 29 April 2025).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1877622","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T05:37:29Z","timestamp":1785476249000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hemodynamic resilience and enhanced early recovery with fospropofol versus propofol in high-BMI patients undergoing surgery: a randomised controlled trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Cuiyuan","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Chengdu Integrated TCM & Western Medicine Hospital","place":["Chengdu, China"]},{"name":"Department of Anaesthesiology, Guangxi Medical University Cancer 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuofeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Chengdu Integrated TCM & Western Medicine Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Ou","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Chengdu Integrated TCM & Western Medicine Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1007\/s40262-018-0672-3","article-title":"Clinical pharmacokinetics and pharmacodynamics of propofol","volume":"57","author":"Sahinovic","year":"2018","journal-title":"Clin 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