The prevention of intraoperative hypotension could reduce postoperative organ injury and mortality, particularly in elderly patients receiving long-term renin-angiotensin system inhibitors. Previous meta-analyses suggest that ciprofol, a novel intravenous anesthetic agent, may provide improved hemodynamic stability compared to propofol; however, its precise effects on perioperative hemodynamics remain unclear. The study will assess whether ciprofol improves perioperative hemodynamic stability in elderly patients receiving renin-angiotensin system inhibitors.
Patients undergoing elective abdominal surgery under general anesthesia
Duration of surgery exceeding 2 hours
Patients receiving long-term renin-angiotensin system inhibitor therapy (>3 months prior to surgery)
Age ≥ 65 years
History of allergy to opioids, propofol, or ciprofol components.
Anticipated difficult airway (limited mouth opening, restricted neck movement, or modified Mallampati grade III-IV) or difficult mask ventilation.
Severe hepatic dysfunction (total bilirubin ≥3.0 mg/dL or AST/ALT ≥2 times the upper limit of normal).
Severe renal impairment (creatinine clearance ≤30 mL/min).