A Comparative Study Protocol Investigating the Association Between Intraoperative Hypotension and the Use of Ring- Versus Propofol-Based Anesthesia in Elderly Patients Undergoing Non-Cardiac Surgery

we conducted this multicentre retrospective cohort study to evaluate the association between the choice of induction agent (ciprofol versus propofol) and the incidence of IOH in geriatric patients having non-cardiac surgery. We hypothesized that ciprofol use would be associated with a lower risk of clinically significant intraoperative hypotension and a reduced overall hypotension burden compared with propofol in routine clinical practice.

Inclusion Criteria: 1. Surgical procedures recorded at the three participating hospitals: NanYi, AnYi, and ZhongDa 2. Surgical procedures with a non-missing PATIENT\_ID 3. Patients who received either ciprofol alone or propofol alone during anesthesia 4. Surgical procedures performed under general anesthesia 5. Surgical procedures with a corresponding record in the anesthesia event dataset 6. Surgical procedures with valid anesthesia start and end times, including times supplemented from operation-room or event records when necessary 7. Surgical procedures with an anesthesia duration greater than 0 minutes and less than 24 hours 8. Surgical procedures with at least one valid intraoperative MAP measurement recorded within the anesthesia time window 9. Patients with available age information 10. Patients with a recorded sex of male or female Exclusion Criteria: 1. Surgical procedures with a missing PATIENT\_ID 2. Procedures involving both ciprofol and propofol, neither drug, missing drug indicators, or other invalid drug coding 3. Non-general anesthesia procedures or procedures for which the anesthesia method could not be confirmed as general anesthesia 4. Surgical procedures with both the operation department and operation name missing 5. Surgical procedures without a corresponding anesthesia event record 6. Surgical procedures with invalid anesthesia timing, including an anesthesia end time earlier than or equal to the anesthesia start time 7. Surgical procedures with an anesthesia duration of 24 hours or longer 8. Surgical procedures without any valid intraoperative MAP measurement within the anesthesia time window 9. Patients with missing age 10. Records with sex values other than male or female