Optimal Propofol Dose with Oxycodone for Visceral Pain Relief in Anxious Patients Undergoing Abortion: A Clinical Trial Report

Introduction/Objective: Patients undergoing induced abortion frequently experience acute visceral pain and preoperative anxiety, the latter of which is known to increase anesthetic requirements. This study aimed to determine the median effective dose (ED50) and the 95% effective dose (ED95) of propofol in combination with oxycodone for alleviating visceral pain, specifically testing the finding that anxiety increases the needed propofol dose. Methods: Female patients, who were scheduled for elective abortion surgeries, with PAS-7 ≥8 were classified as anxious group (Group A), while those with PAS-7 < 8 were classified as non-anxious group (Group N). Both groups received an intravenous dose of 0.10 mg/kg of oxycodone prior to surgery.And 2 to 3 minutes later, the first patient in the sequence received an initial dose of 3.50 mg/kg of propofol, with subsequent doses determined by Dixon's up-and-down method. Results: The ED50 (95% CI) for propofol was 1.96 mg/kg (1.87-2.05) in Group N and 2.42 mg/kg (2.30-2.53) in Group A; the ED95 (95% CI) was 2.10 mg/kg (2.03-2.39) and 2.60 mg/kg (2.50-2.95), respectively. The lack of overlap in the 95% confidence intervals indicates a statistically significant difference between groups. Conclusion: The combination of 0.10 mg/kg oxycodone and propofol was effective for visceral pain suppression during artificial abortion. Notably, patients with anxiety required higher doses of propofol to achieve satisfactory pain relief during abortion surgeries. Trial Registration: This human study was approved by the Medical Ethics Committee of the People's Hospital of Qiannan (QNZY-QNYZKYRC-23-0801) and registered at https://www.chictr.org.cn/ (Date: 09/26/2023, ChiCTR2300076169).