Cipepofol Anesthesia Induction Improves Hemodynamic Stability for High-Risk CV Patients: Study

A new study published in the Journal of American Medical Association found that cipepofol demonstrated superior hemodynamic stability compared to propofol when used at equipotent doses and similar anesthesia depths in patients with aortic stenosis (AS). These findings suggest that cipepofol may be a safer alternative induction agent for patients with high cardiovascular risk.

For individuals with severe aortic stenosis, transcatheter aortic valve replacement (TAVR) is a less intrusive option than surgical aortic valve replacement. A frequent consequence that might arise from the induction of anesthesia to the initial surgical incision is arterial hypotension, especially in elderly patients whose preoperative physical condition is already weakened.

Cipepofol, sometimes called ciprofol, is a short-acting derivative of propofol that increases the γ-aminobutyric acid type A receptor's sensitivity. Thus, to determine if cipepofol performs better than propofol in preserving postinduction hemodynamic stability in patients with AS, Tingting Ni and team carried out this investigation.

From June 29, 2023, until July 8, 2024, this clinical study was carried out at Zhejiang University School of Medicine's Second Affiliated Hospital in China. Inclusion criteria were patients with AS who were planned for transcatheter aortic valve replacement (TAVR). Propofol or cipepofol was administered as anesthesia induction drugs at equipotent dosages to participants in a 1:1 randomized trial. The area under the curve (AUC) of the mean arterial pressure (MAP) variation from baseline during the first 15 minutes after induction was the main result.

This study assigned 124 AS patients scheduled for TAVR to either the propofol group (n = 62) or the cipepofol group (n = 62). Out of the 124 patients that were randomly assigned, one patient was eliminated from each group because they were not eligible for the TAVR treatment. The intention-to-treat principle was used to evaluate the data for 122 patients. The mean (SD) age of the 122 patients was 72.2 (5.0) years, and 53 patients (43.4%) were female. The median (IQR) AUC was much lower in the cipepofol group.

Also, the cipepofol group needed a lower median (IQR) dosage of norepinephrine within the first 15 minutes postinduction and showed a considerably lower incidence of postinduction hypotension than the propofol group. Furthermore, the bispectral indices of the two groups were similar. Overall, cipepofol offered better hemodynamic stability during anesthesia induction than propofol, suggesting that it would be a safer option for this group.

Source:

Ni, T., Zhou, X., Wu, S., Lv, T., Hu, Y., Gao, Q., Luo, G., Xie, C., Zou, J., Chen, Y., Zhao, L., Xiao, J., Tao, X., Yi, Y., Xu, Z., Wang, T., Zhou, J., Yao, Y., & Yan, M. (2025). Hemodynamic impact of cipepofol vs propofol during anesthesia induction in patients with severe aortic stenosis: A randomized clinical trial: A randomized clinical trial. JAMA Surgery. https://doi.org/10.1001/jamasurg.2025.1299