Using transthoracic echocardiography (TTE) to compare the hemodynamic effects of Ciprofol and Propofol during the induction phase of general anesthesia: A prospective, double-blind, randomized, controlled trial

Background Cipropfol,a new intravenous anesthetic,is structurally and pharmacologically similar to propofol. However, its impact on cardiac function and hemodynamics during anesthesia induction compared to propofol is unclear. This study uses echocardiography to compare cardiac systolic and diastolic performance and hemodynamic measures between Ciprofol and Propofol during anesthesia induction. Methods A total of 204 patients aged 18–65 years, regardless of gender, with ASA physical status I-Ⅱ, BMI 18–30 kg/m ² , and modified Mallampati classification I-II, were selected for pain-free gastroscopy. They were randomly divided into two groups: Group C (n = 99) received 0.2–0.4 mg/kg of Ciprofol, and Group P (n = 105) received 2–4 mg/kg of Propofol. Each patient was intravenously given 5-7ug/kg of Alfentanil. Pain - free endoscopy started when the MOAA/S score reached ≤ 1. At two time points (T ₀ :before anesthesia induction;T ₁ :MOAA/S ≤ 1), TTE indices (Sa, Ea, TAPSE values) and monitor data (HR, SBP, DBP, MAP) were recorded for both groups. The study also recorded the incidence of successful sedation, the utilization rate of vasoactive medications (Ephedrine and Atropine), the incidence of injection-related pain, respiratory depression, coughing, intraoperative movements, bradycardia, agitation during recovery, and other adverse reactions like nausea and vomiting within 48 hours post - surgery for both groups. Results The success rate of sedation in both groups was 100%. Upon induction of general anesthesia, the Sa level in the Ciprofol group was observed to be higher than that in the Propofol group (8.73 ± 1.37 vs 8.21 ± 1.10, p  = 0.004), SBP in the Ciprofol group was significantly higher than that in the Propofol group (105.44 ± 16.45 vs 100.26 ± 14.10, p  = 0.016). Conclusion Ciprofol exhibits superior hemodynamic stability during the induction of general anesthesia compared to Propofol, the benefit might due to its ability to preserve cardiac contractile function, particularly that of the left ventricle. Clinical Trials Registration : https://www.chictr.org.cn/indexEN.html, identifier ChiCTR2500095938.