Comparison of Ciprofol and Propofol on Postoperative Quality of Recovery and Intraoperative Cerebral Oxygen Saturation in Patients Undergoing Thoracoscopic Thoracic Surgery: A Randomized, Double-Blind, Non-Inferiority Trial

Abstract

Purpose Ciprofol provides more stable induction, though its impact on patients’ quality of recovery (QoR) and brain oxygenation requires clarification. This trial assessed whether propofol anesthesia is non-inferior to ciprofol regarding postoperative recovery quality, while additionally comparing their effects on intraoperative cerebral oxygenation. Patients and Methods This single-center, randomized, double-blind, non-inferiority study involved 94 patients scheduled for elective surgery, randomized equally to receive ciprofol (Group C) or propofol (Group P). The primary outcome was the global QoR-15 score measured 24 hours after surgery, with a non-inferiority threshold set at −6.0. Secondary outcomes included 48-hour QoR-15 scores, injection pain frequency, vasopressor requirements, and regional cerebral oxygen saturation (rScO2). Results Eighty- eight patients completed the study (Group C: 44; Group P: 44). In ITT analysis, the mean QoR-15 score at 24 hours for Group C was non-inferior to Group P (Pnon-inferiority < 0.001), with consistent findings in the PP analysis. Similar non-inferiority was observed at 48 hours. However, Group C experienced a notably lower rate of injection pain (4.5% vs 59.0%, P < 0.001) and required less phenylephrine (P = 0.009). Although Group P had higher heart rates after induction of anesthesia (P < 0.05), its average arterial pressure was notably reduced (P < 0.05). Notably, rScO2 in group C was higher than that in group P after induction of anesthesia (P = 0.046) and during the anesthesia maintenance phase (P < 0.05). Conclusion Ciprofol is non-inferior to propofol regarding early postoperative recovery quality. Furthermore, ciprofol mitigates injection pain, reduces vasoconstrictor requirements, and better maintains cerebral oxygenation.