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Abstract Background Propofol has been the gold standard for anesthesia induction and maintenance due to its rapid onset and favorable pharmacokinetic properties. However, the search for alternative agents with improved safety and efficacy has led to the emergence of ciprofol (HSK3486), a structural analog of propofol. This systematic review and meta-analysis aim to comprehensively assess the safety and efficacy of ciprofol compared to propofol for anesthesia induction and maintenance in adult patients undergoing surgical procedures. Methods This study included only double-arm RCTs in which participants were aged eighteen or older undergoing surgery. For the statistical analysis of the extracted data, we employed RevMan 5.4.1. Results Ciprofol demonstrated a promising trend of higher anesthesiologists’ satisfaction during the induction phase (MD 0.14, 95%, CI − 0.28 to 0.56, p = 0.51), whereas Propofol was favored during maintenance. Propofol also exhibited advantages with a shorter time to successful anesthesia induction (MD 0.08 min, 95% CI 0.00 to 0.15, p = 0.04), and quicker attainment of full alertness (MD 0.11 min, 95% CI − 1.29 to 1.52, p = 0.87), suggesting its efficiency in clinical practice. Importantly, there were no significant disparities in the success rate of anesthesia. Conclusion Both ciprofol and propofol demonstrate comparable efficacy and safety for anesthesia induction and maintenance in adult patients undergoing surgery. While propofol provides a faster onset of induction, ciprofol exhibits advantages in terms of pain management. Clinicians should consider these findings when selecting anesthetic agents, and tailoring choices to individual patient needs and clinical scenarios.

Madam, lung cancer is one of the commonly diagnosed causes of cancer mortality and morbidity worldwide, accounting for approximately 1.76 million deaths annually.1 In the past overall survival in patients with non-small cell lung cancer (NSCLC) remained uncertain. Many treatment regimens were under trial2 until, a breakthrough study incorporating neoadjuvant nivolumab with chemotherapy showed tremendous success in phase 3 CheckMate 816 trail3. Moreover, the FDA has recently approved this therapy for early-stage NSCLC.4 Nivolumab is an anti–programmed death 1 (PD-1) human antibody, which restores antitumor T cells activity. Whereas platinum-doublet chemotherapy improves antitumor immunity.3 In this trail, approximately 350 patients were randomly assigned in an equal ratio to receive nivolumab (360 mg) plus chemotherapy or chemotherapy alone for consecutive 3 weeks for three cycles before surgery. Two primary end points were established, event-free survival and complete pathological response. Median event-free survival was 31.6 months with nivolumab plus chemotherapy compared to 20.8 months with chemotherapy alone (hazard ratio for disease progression, recurrence, or death, 0.63; P=0.005). The pathological complete response was 24.0% in the nivolumab plus chemotherapy group and 2.2% in chemotherapy alone group (odds ratio, 13.94; P