Impact of Anxiety or Depression Symptoms on Propofol Requirements for Sedation in Females: A Prospective Cohort Study

Abstract

Mental disorders are thought to affect various clinical outcomes during the perioperative period. Among them, anxiety and depression are 2 of the most common types. However, the impacts of anxiety or depression on propofol requirements remain unclear. This study aimed to investigate the effects of anxiety or depression symptoms on the propofol requirements for sedation in females. This study recruited female patients aged 18 to 65 years, with American Society of Anesthesiologists physical status classification of 1 to 2, who were scheduled for hysteroscopic surgery under propofol‐based intravenous anesthesia. The day before surgery, the Hospital Anxiety and Depression Scale (HADS) was used to assess the symptoms of anxiety and depression within the past 6 months. Target‐controlled propofol was gradually titrated to achieve 3 desired levels of sedation: Modified Observer's Assessment of Alertness/Sedation scale (MOAA/S) score 3, MOAA/S score 1, and MOAA/S score 1 and Narcotrend Index <65. The effect‐site concentration of propofol correlated with HADS–Anxiety scores for the sedation levels of MOAA/S 3 and 1 (r = .249, P = .008; and r = .190, P = .045, respectively). However, the propofol requirements did not correlate with HADS–Depression scores at any sedation level. In conclusion, female patients with anxiety symptoms, but not depression symptoms, required a higher dose of propofol for sedation in hysteroscopy.

The Effect of Relaxation Therapy on Hypoxia During Intravenous Propofol Anesthesia in Patients With Pre-operative Anxiety: A Prospective Randomized Controlled Trial

“…Higher levels of anxiety among patients increased their needed amount of propofol intraoperatively. These results were similar to the results of Li Ruiyun ( 36 ). Music has a sedative effect on patients.…”

UPLC-MS-Based Serum Metabolic Profiling Reveals Potential Biomarkers for Predicting Propofol Responsiveness in Females

“…Serum samples were collected from patients recruited in a clinical trial of female patients undergoing propofol-based intravenous anesthesia for elective hysteroscopic surgery. The detailed descriptions of the inclusion/exclusion criteria and induction of anesthesia have been published previously . Briefly, no premedication was administrated.…”

“…A propofol dose–distribution curve was drawn based on the effect-site concentration of the participants (detailed information has been described previously) . In a discovery set, 24 serum samples were collected randomly from the lowest and the top 15% of the propofol dose–distribution curve, defined as good ( n = 12) and poor responders ( n = 12), respectively.…”

“…The detailed descriptions of the inclusion/exclusion criteria and induction of anesthesia have been published previously. 36 Briefly, no premedication was administrated. When a patient arrived at an operating room, 5 mL of venous blood sample was collected.…”

“…A propofol dose−distribution curve was drawn based on the effect-site concentration of the participants (detailed information has been described previously). 36 In a discovery set, 24 serum samples were collected randomly from the lowest and the top 15% of the propofol dose−distribution curve, defined as good (n = 12) and poor responders (n = 12), respectively. Moreover, an independent set of 16 serum samples was used to validate the candidate biomarkers, including 4 serum samples randomly selected from the lowest 15% of propofol dose− distribution curve, 8 serum samples randomly selected from the middle 70% of propofol dose−distribution curve, and 4 serum samples randomly selected from the top 15% of propofol dose− distribution curve.…”