The Effect of Preoperative Heart Rate and Anxiety on the Propofol Dose Required for Loss of Consciousness

Gras, S.; Servin, Frédérique; Bedairia, E.; Montravers, Philippe; Desmonts, Jean-Marie; Longrois, Dan; Guglielminotti, Jean

doi:10.1213/ane.0b013e3181c5bd11

Cited by 47 publications

(39 citation statements)

References 28 publications

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“…We also observed that STAI-S measured in the operating room had a strong positive correlation with HR ( Figure 5). This is in agreement with Morely et al 9 and Gras S et al 10 Conflicting results have been reported in the previous studies concerning the effects of anxiety on Propofol dose requirement for induction. Maranets et al found that increased preoperative STAI-T on the day of surgery was associated with higher Propofol bolus dose to achieve a BIS (bispectral index) value between 40 and 60.…”

Section: Discussionsupporting

confidence: 92%

“…9 Gras S et al found no strong correlation between state and trait anxiety with propofol dose requirement for loss of consciousness (LOC). 10 They found significant positive correlation between HR in the operating room and propofol dose and also between STAI-S in the operating room and HR, thereby supporting an indirect effect of pre-anesthetic anxiety through changes in the HR.…”

Section: Discussionmentioning

confidence: 88%

“…This is in contrary with Gras S et al who found strong positive correlation only between HR and Propofol dose requirement. 10 It has been proven a long back that anxiety is associated with a raise in both HR and cardiac output (CO). 11,12,20 Fell et al suggested that anxiety and stress-induced adrenaline release may account for the preoperative increase in HR and CO. 21 Anxiety causes increase in catecholamine levels through sympathetic surge.…”

Section: Discussionmentioning

confidence: 99%

“…But the STAI is the best scoring method available till now used in most of the related studies. [5][6][7]10 It would have been more accurate if we had used propofol arterial concentrations and cardiac output measurements. Use of BIS or any other EEG (electroencephalogram) analog/depth indicators would have been helpful in confirming the level of depth of anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…5,8 But some recent studies have come with different results. 9,10 Anxiety and acute mental stress are associated with increased heart rate (HR) and cardiac output 11,12 and studies have shown that increased cardiac output increases the propofol requirements. [13][14][15][16] Hence hemodynamic status during induction of anesthesia may modify propofol Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study requirements.…”

Section: Introductionmentioning

confidence: 99%

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Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study

Hazra

Das

et al. 2017

Asian J Med Sci

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Background: Though anxiety is associated with increase in heart rate and cardiac output, there is conflicting reports regarding its effect on propofol induction dose. Aims and Objectives: The aim of the study was to delineate the correlation between pre-anesthetic anxiety and heart rate on propofol requirement for induction. Materials and Methods: Total 42 patients of ASA (American Society of Anesthesiologists) physical status I and II, 13 male and 29 female, aged between 18 to 50 years and scheduled for elective surgery under general anesthesia, were enrolled in this study. Trait anxiety in the waiting room and state anxiety both in the waiting room and operating room were assessed using Spielberger's revised State-Trait Anxiety Inventory (STAI) scale. After heart rate (HR) recording, anesthesia was induced with 200 ml/hr 1% propofol infusion till loss of verbal contact. Results: Pre-anesthetic trait anxiety and HR had strong positive correlation with propofol requirement (ρ>0.6, P<0.05) while state anxiety had not. But pre-anesthetic state anxiety measured just before induction is strongly associated with increase in HR (ρ>0.6, P<0.05).Conclusion: Pre-operative anxiety should be considered and the dose of propofol should be titrated for induction accordingly. Further, larger trials with more sophisticated monitoring are needed to confirm our findings.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study

Hazra

Das

et al. 2017

Asian J Med Sci

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

Lin

Jiang

et al. 2020

The Journal of Clinical Pharma

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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.

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Towards Integrated Procedural Comfort Care: Redefining and Expanding “Non-pharmacology”

Sahyoun

Cozzi

Leroy

et al. 2021

Pediatric Sedation Outside of the Operating Room

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The Effect of Preoperative Heart Rate and Anxiety on the Propofol Dose Required for Loss of Consciousness

Abstract: Increased perioperative HR is associated with increased propofol dose required for LOC. Perioperative anxiety accounts for increased HR.

Cited by 47 publications

References 28 publications

Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study

Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study

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

Towards Integrated Procedural Comfort Care: Redefining and Expanding “Non-pharmacology”

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