Comparison of postoperative awakening between ciprofol and propofol in elderly patients undergoing hip replacement under BIS monitoring

doi:10.12092/j.issn.1009-2501.2026.01.008

Abstract

Abstract:

AIM: To compare the difference between ciprofol and propofol continuous infusion for postoperative awakening in elderly patients undergoing hip replacement. METHODS: A total of 68 patients aged 65-85 years, who underwent elective hip replacement surgery were randomly assigned into two groups (n=34 each): group C and group P. In group C, anesthesia was induced with ciprofol 0.3 mg/kg, sufentanil 0.3 μg/kg and cisatracurium 0.15 mg/kg. Anesthesia was then maintained with a continuous infusion of ciprofol at a rate of 0.8 mg·kg^?1·h^?1 and remifentanil at 1.2 to 12 μg·kg^?1·h^?1. The Bispectral Index (BIS) value was kept between 40 and 60, and blood pressure was maintained within ±20% of the baseline. In group P, ciprofol was replaced by propofol at an induction dose of 1.5 mg/kg and a maintenance dose of 5.0 mg·kg^?1·h^?1. Record amount of intraoperative anesthetic dosage, blood loss, volume of fluid input, urine volume, vasoactive drugs usage and intraoperative hemodynamic indexes, postoperative awakening time, spontaneous breathing recovery time, extubation time, and the time required to achieve a modified Aldrete score ≥9, and MOAA/S scores and adverse reactions at 0, 5, 15, and 30 minutes after extubation. RESULTS: Compared to group P, group C exhibited significantly prolonged awakening time, spontaneous breathing recovery time, and extubation time (P<0.05). Additionally, the volume of intraoperative fluid infusion was significantly reduced (P<0.05), urine volume was significantly increased (P<0.05), and the utilization of vasoactive drugs was significantly decreased (P<0.05) in group C. No significant differences were observed between the two groups in terms of the time for modified Aldrete score ≥9, MOAA/S score at 0, 5, 15 and 30 min after extubation, as well as adverse reactions (P>0.05). The dosage of remifentanil in group C showed a significant increase (P<0.05), while the intraoperative maintenance dose of ciprofol was determined to be at a rate of 0.849 mg·kg^?1·h^?1 (range: 0.456 to 1.222 mg·kg^?1·h^?1). CONCLUSION: Compared with propofol, the postoperative awakening time, spontaneous breathing recovery time and extubation time of ciprofol in elderly patients undergoing hip replacement are prolonged, and the intraoperative hemodynamics is more stable. The maintenance dose of ciprofol in elderly patients is 0.849 mg·kg^?1·h^?1.

Key words: ciprofol, elderly patients, hip replacement, postoperative awakening time

CLC Number:

R614

Jianyou ZHANG, Yi GONG, Luyu SUN, Suhong TANG, Dawei YANG, Jie ZHOU. Comparison of postoperative awakening between ciprofol and propofol in elderly patients undergoing hip replacement under BIS monitoring[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(1): 72-77.

Figures/Tables 5

References 20

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Item	C group (n=34)	P group (n=31)	χ²/Z/t	P
Gender (Male/Female, n)	16/18	14/17	0.023	0.878
Age [year, M (Q₁, Q₃)]	73.00 (71.00,77.00)	74.00 (67.00,78.25)	0.000	1.000
BMI (kg/m²,$ \overline{x} $±s)	22.11±3.22	23.16±3.29	1.300	0.198
ASA (I/II, n)	8/26	9/22	0.254	0.614
Type of surgery (%)			1.143	0.285
Hemiarthroplasty	20.6	32.3
Total hip replacement	79.4	67.7
Time of surgery (min,$ \overline{x} $±s)	73.12±17.99	74.48±26.41	0.246	0.807
Drug pumping time (min,$ \overline{x} $±s)	88.09±19.88	91.35±25.94	0.573	0.569
Amount of bleeding (mL,$ \overline{x} $±s)	185.29±50.04	213.06±76.43	1.748	0.085
Fluid replacement (mL,$ \overline{x} $±s)	777.94±257.67	959.68±309.41^b	2.581	0.012
Urine volume (mL,$ \overline{x} $±s)	243.53±108.01	189.19±105.47^b	2.049	0.045
Vasoactive drug (with/without, n)	14/20	21/10^b	4.605	0.032

Item	C group (n=34)	P group (n=31)	χ²/Z/t	P
Gender (Male/Female, n)	16/18	14/17	0.023	0.878
Age [year, M (Q₁, Q₃)]	73.00 (71.00,77.00)	74.00 (67.00,78.25)	0.000	1.000
BMI (kg/m²,$ \overline{x} $±s)	22.11±3.22	23.16±3.29	1.300	0.198
ASA (I/II, n)	8/26	9/22	0.254	0.614
Type of surgery (%)			1.143	0.285
Hemiarthroplasty	20.6	32.3
Total hip replacement	79.4	67.7
Time of surgery (min,$ \overline{x} $±s)	73.12±17.99	74.48±26.41	0.246	0.807
Drug pumping time (min,$ \overline{x} $±s)	88.09±19.88	91.35±25.94	0.573	0.569
Amount of bleeding (mL,$ \overline{x} $±s)	185.29±50.04	213.06±76.43	1.748	0.085
Fluid replacement (mL,$ \overline{x} $±s)	777.94±257.67	959.68±309.41^b	2.581	0.012
Urine volume (mL,$ \overline{x} $±s)	243.53±108.01	189.19±105.47^b	2.049	0.045
Vasoactive drug (with/without, n)	14/20	21/10^b	4.605	0.032

Item	C group (n=34)	P group (n=31)	Z/t	P
Awakening time (min)	10.00 (7.00,13.25)	7.00 (5.00,10.00)^b	2.381	0.017
Spontaneous breathing recovery time (min)	8.50 (5.00,12.25)	5.00 (3.00,10.00)^b	2.553	0.011
Extubation time (min)	11.50 (8.00,16.00)	9.00 (7.00,13.00)^b	2.043	0.041
Time to reach a modified Aldrete score ≥ 9 (min,$ \overline{x} $±s)	13.15±5.81	10.77±6.06	1.611	0.112

Item	C group (n=34)	P group (n=31)	Z/t	P
Awakening time (min)	10.00 (7.00,13.25)	7.00 (5.00,10.00)^b	2.381	0.017
Spontaneous breathing recovery time (min)	8.50 (5.00,12.25)	5.00 (3.00,10.00)^b	2.553	0.011
Extubation time (min)	11.50 (8.00,16.00)	9.00 (7.00,13.00)^b	2.043	0.041
Time to reach a modified Aldrete score ≥ 9 (min,$ \overline{x} $±s)	13.15±5.81	10.77±6.06	1.611	0.112

Group	0	5 min	15 min	30 min
C group (n=34)	4 (4,5)	5 (5,5)	5 (5,5)	5 (5,5)
P group (n=31)	4 (4,4)	5 (5,5)	5 (5,5)	5 (5,5)
Z	1.478	1.585	0.955	0.955
P	0.140	0.113	0.340	0.340