Effect of ciprofol versus propofol on postoperative recovery quality after laparoscopic surgery under general anesthesia: a prospective, randomized, parallel controlled study

Ciprofol (HSK3486) is a novel gamma-aminobutyric acid type A (GABA A ) receptor agonist that provides anesthetic efficacy comparable to propofol. This study compared the postoperative recovery quality of ciprofol versus propofol in patients who underwent laparoscopic surgery under general anesthesia. In this prospective, single-center, randomized, parallel controlled study (ChiCTR2400085402), patients who were scheduled for elective laparoscopic surgery under general anesthesia were recruited. Patients were randomly assigned in a 1:1 ratio to receive ciprofol or propofol for anesthesia induction and maintenance. The primary endpoint was the restlessness score (RS) after awakening. Between August 9, 2024, and September 29, 2025, 94 patients were randomly assigned to receive ciprofol ( n = 47) or propofol ( n = 47). Patients in the ciprofol group exhibited significantly lower mean RS after awakening (0.17 ± 0.38 vs. 0.48 ± 0.62, P = 0.005), with a higher proportion of patients achieving an RS after awakening of 0 (83.0% vs. 58.7%; P = 0.012). The mean quality of recovery-15 (QoR-15) total score on the first day after surgery was 125.38 ± 11.42 in the ciprofol group and 120.60 ± 10.47 in the propofol group ( P = 0.037), with a mean difference of 4.780 (95% confidence intervals [CI], 0.298–9.277). BIS and vital signs were generally comparable between the two groups at different time points. Times from discontinuation of anesthetic agents to leaving the operating room (15.55 ± 8.88 min vs. 15.20 ± 9.90 min, P = 0.857), extubation (14.19 ± 9.65 min vs. 12.53 ± 8.71 min, P = 0.390), and recovery of spontaneous breathing (5.98 ± 2.66 min vs. 5.50 ± 2.13 min, P = 0.341) were comparable between the ciprofol and propofol groups. No patients in either group experienced intraoperative awareness. Ciprofol also resulted in significantly lower incidences of injection-site pain (2.13% vs. 23.40%; P = 0.002) than propofol. The incidences of postoperative nausea and vomiting were 12.77% and 21.28%, respectively. Compared with propofol, ciprofol was associated with reduced emergence agitation and injection-site pain in patients undergoing laparoscopic surgery under general anesthesia. Chinese Clinical Trial Registry ChiCTR2400085402. URL: https://www.chictr.org.cn/hvshowprojectEN.html?id=253892&v=1.0 . Date of Registration: 2024-06-06.