# The effect of ciprofol on the incidence of postoperative delirium in adult surgical patients: a meta-analysis and meta-regression

## TL;DR

This study finds that ciprofol reduces postoperative delirium more than propofol, especially in trunk surgery and total intravenous anesthesia cases.

## Contribution

The study provides new evidence that ciprofol offers better neurocognitive protection than propofol in specific surgical contexts.

## Key findings

- Ciprofol significantly lowers postoperative delirium incidence compared to propofol.
- The benefit is more pronounced in trunk surgery and total intravenous anesthesia patients.
- Results remain robust despite high heterogeneity across studies.

## Abstract

To systematically evaluate the impact of ciprofol on the incidence of postoperative delirium (POD) in adult surgical patients and to explore potential sources of heterogeneity.

A systematic search was conducted in databases including PubMed, Web of Science, OVID, EMBASE, and the Cochrane Library to identify clinical studies published before October 2025 comparing ciprofol vs. propofol for general anesthesia. The Newcastle-Ottawa Scale was employed to assess study quality. Meta-analysis and meta-regression were performed using R software to calculate the POD incidence and its 95% confidence interval (CI). Subgroup analysis and sensitivity analysis were conducted to explore sources of heterogeneity.

Seven studies involving 4,171 patients were included. The overall POD incidence in the ciprofol group was 11.30% (95% CI: 0.77%−21.83%), which was significantly lower than that in the propofol group (19.51%; 95% CI: 2.51%−36.50%). Subgroup analysis revealed that the advantage of ciprofol in reducing POD incidence was more pronounced in patients undergoing trunk surgery (19.29% vs. 0.56%) and in those receiving total intravenous anesthesia (2.93% vs. 14.33%). Meta-regression did not identify significant correlations between POD incidence and age, sex distribution, or intraoperative hypotension. Significant heterogeneity was observed across studies (I2 > 85%), but sensitivity analysis confirmed the robustness of the results.

Compared with propofol, ciprofol significantly reduces the risk of POD in surgical patients, with particularly pronounced benefits in those undergoing trunk surgery and receiving total intravenous anesthesia. These findings provide new evidence for perioperative neurocognitive protection.

INPLASY International Platform, registration number: INPLASY202610019, DOI: 10.37766/inplasy2026.1.0019.