Study Summary

Sixty elderly patients undergoing elective spinal surgery with intraoperative neurophysiological monitoring were randomized to receive ciprofol or propofol. The primary outcomes of interest was the amplitudes of lower extremity motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs) at the completion of the critical surgical phase (T6). Secondary outcomes included MEP and SEP latencies, amplitudes at 50 minutes after the cessation of cis-atracurium (T5), hemodynamic parameters including heart rate (HR), mean arterial pressure (MAP), bispectral index (BIS), incidence of hypotension and bradycardia, vasoactive medication requirements, and recovery characteristics. Outcomes were assessed from baseline through completion of the critical surgical phase. Overall, the results of the study revealed that ciprofol produced significantly higher MEP and SEP amplitudes with comparable latencies relative to propofol, while also providing greater hemodynamic stability and lower rates of hypotension and vasoactive drug use. These findings suggest that ciprofol may be a preferable anesthetic alternative to propofol for elderly patients undergoing spinal surgery requiring intraoperative neurophysiological monitoring.