Jun Lu,1,* Yewei Shi,1,* Xin Lan,1 Guangling Tang,1 Yi Shao,1 Chao Chen,1 Xinglong Xiong,1 Dongxu Chen,2,3 Jing Shi1 

1Department of Anesthesiology, Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China; 2Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu, People’s Republic of China; 3Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jing Shi, Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China, Tel +86-18685034016, Email shijing81@gmc.edu.cn Dongxu Chen, Department of Anesthesiology, West China second Hospital, Sichuan University, Chengdu, People’s Republic of China, Tel +86-15881730901, Email scucdx@foxmail.com

Purpose: To investigate the effects of ciprofol on postoperative cognitive function in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Patients and Methods: A total of 138 patients who underwent cardiac surgery with cardiopulmonary bypass were included in this prospective, randomized, controlled study. Patients were randomized into two groups: the Ciprofol group (Group C) and the Propofol group (Group P). During anesthesia induction and maintenance, the patients in Group C received ciprofol, whereas those in Group P received propofol. The primary outcome measure was the incidence of postoperative delirium (POD), which was assessed twice daily for 7 days after surgery via either the Confusion Assessment Method (CAM) or the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Statistical analyses included chi-square tests for categorical outcomes and relative risk calculations for POD. Additionally, delirium subtypes were recorded. The incidence of postoperative cognitive dysfunction (POCD) was evaluated at 1 and 3 months after surgery using the Telephone Montreal Cognitive Assessment (T-MoCA). Furthermore, the occurrence of postinduction adverse events, including hypotension, bradycardia, and tachycardia, as well as the incidence of postoperative complications, were also documented.
Results: POD occurred in 19/64 (29.69%) patients in the Ciprofol group and 34/65 (52.31%) patients in the Propofol group (RR = 0.57; 95% confidence interval = 0.37 to 0.88; p = 0.009). There was no significant difference in the incidence of POCD at 1 month (22.03% vs 26.62%, p = 0.547) or 3 months (16.25% vs 16.00%; p = 0.771) after surgery between the two groups.
Conclusion: Ciprofol was found to decrease the incidence of POD in patients who underwent cardiac surgery with cardiopulmonary bypass. Nevertheless, no significant effect of this intervention on the incidence of POCD was demonstrated at either 1 or 3 months after surgery. A reduction in the incidence of delirium may be associated with improved postoperative recovery, shortened hospital stays, and a decrease in long-term cognitive impairments.
Registration: The study had been registered in the Chinese Clinical Trials Registry (www.chictr.org.cn; Trial Identifier: ChiCTR2200061712).

Keywords: ciprofol, cardiopulmonary bypass, cardiac surgery, delirium, cognitive function