From propofol to cipepofol (Cypsedo®), a new intravenous general anesthetic approved for adults undergoing surgery

Abstract

Propofol ( 1 ) remains the gold standard intravenous general anesthetic despite such drawbacks as injection pain, respiratory depression, and cardiovascular instability. The newly FDA-approved cipepofol (Cypsedo ® , 2 ) is a chiral analog incorporating a cyclopropyl ring to enhance stereospecifc binding to GABA A receptors. Due to its four- to five-fold greater potency, cipepofol achieves anesthetic efficacy at lower induction doses (0.4–0.5 mg/kg). It retains favorable pharmacokinetic properties of propofol, including rapid onset and short duration of action, while requiring a lower lipid load in its formulation. Clinical studies have demonstrated reduced post-induction hypotension, markedly less injection pain, and improved hemodynamic stability, making it an attractive alternative for patients at increased cardiovascular or respiratory risk.