Abstract:Objective To compare the anesthesia quality and postoperative recovery quality between ciprofol and propofol for total intravenous anesthesia in elderly patients with colon cancer undergoing laparoscopic radical resection，and to provide evidences for optimizing clinical anesthesia selection. Methods A total of 156 patients scheduled to undergo laparoscopic radical resection of colon cancer in the First People’s Hospital of Zhangjiagang from January 2023to January 2025 were prospectively included. According to the random number table method，they were divided into ciprofol group（group C）and propofol group（group P），with 78 patients in each group. Anesthesia was maintained by pumping ciprofol 0.4-3 mg/（kg·h）and remifentanil 0.05-2 μg/（kg·min）in group C，and propofol 4-12 mg/（kg·h）and remifentanil 0.05- 2 μg/（kg·min）in group P，and intermittent intravenous injection of rocuronium as needed to maintain the muscle relaxation effect. Intraoperative mean arterial pressure（MAP）and heart rate（HR）were recorded.Richmond agitation-sedation scale（RASS）scores were assessed in the post-anesthesia care unit（PACU）. Anesthesia induction time，extubation time，and PACU stay were recorded. Intraoperative adverse events，including injection pain，hypotension，hypertension，bradycardia，and tachycardia，were observed，as well as adverse events in the PACU. The 15-item quality of recovery scale（Qor-15）was used to evaluate postoperative recovery. Results Instant MAP at the time of endotracheal intubation was significantly lower in group P compared to group C（P<0.05）. No significant differences were observed in RASS scores after extubation，as well as anesthesia induction time，extubation time，or PACU stay between the two groups（P>0.05）. The non-，mild-，moderate- and severe-injection pain were 17，33，19 and 9 cases in group P，and 67，5，5 and 1 case in group C，respectively. The degree of injection pain in group P was significantly higher than that in group C （Z=7.544，P<0.01）. The incidence of intraoperative hypotension in group P was significantly higher than that in group C（51.3% vs 26.9%，χ2=9.718，P=0.002）. No significant difference was found in the incidence of adverse events in the PACU，and postoperative Qor-15 scores on postoperative days 1，2，and 3between the two groups（P>0.05）. Conclusion In laparoscopic radical resection of colon cancer in the elderly patients，total intravenous anesthesia with ciprofol or propofol can achieve good anesthesia effects and postoperative recovery quality. Compared with propofol，ciprofol has certain advantages in maintaining hemodynamic stability and the injection pain is more mild. Therefore，ciprofol can be used as a safe and effective anesthesia choice in laparoscopic surgery for elderly patients with colon cancer.