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

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 GABAA 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.