Efficacy and Safety of Ciprofol for Sedation in Critically Ill Patients After Cardiac Surgery: A Single-Center, Prospective, Randomized Controlled Trial

Purpose: This study aimed to compare the efficacy and safety of ciprofol and propofol for sedation in critically ill patients after cardiac surgery. Patients and Methods: In this prospective, randomized controlled trial, 123 patients undergoing coronary artery bypass grafting (CABG) and/or valve surgery were randomly assigned to receive either ciprofol (Group C) or propofol (Group P) for postoperative sedation in the intensive care unit (ICU). Midazolam was administered if additional sedation was required, and remifentanil was used for analgesia. Sedation and analgesia were titrated to a target Richmond Agitation-Sedation Scale (RASS) score of -2 to +1 and a Critical-Care Pain Observation Tool (CPOT) score < 3. The primary endpoint was the mean sedation compliance rate, defined as the percentage of RASS scores within the target range during the initial 24 hours. Secondary endpoints included safety events, extubation time, length of ICU stay, mortality, delirium incidence, and postoperative recovery. Results: > 0.05). Conclusion: In summary, ciprofol provides non-inferior sedation efficacy and a comparable safety profile to propofol in critically ill patients following cardiac surgery. A numerical trend toward lower hypotension incidence was observed with ciprofol, which warrants further validation in future studies.