Key result
Propofol administration linked to ~3% incidence of intra-operative cardiac arrest in elective surgery.
Why the study?
The link between individual anesthetic agents, particularly propofol, and intra-operative cardiac arrest requires ongoing scrutiny to improve anesthesia safety.
Does propofol administration increase the risk of intra-operative cardiac arrest in adults undergoing elective surgical procedures?
Cross-Sectional (n=125)
No
Does propofol administration increase the risk of intra-operative cardiac arrest in adults undergoing elective surgical procedures?
In a cohort of mostly young and healthy patients undergoing elective surgery, propofol administration was temporally associated with a 3.2% incidence of intra-operative cardiac arrest, highlighting the need for vigilant hemodynamic monitoring.
Propofol administration was temporally associated with arrest in low-risk elective cases; hypothesis-generating and should not yet change practice.
Perioperative cardiac complications continue to challenge anesthetists, as a range of drugs used in the operating room can disturb heart function and trigger serious events. Although numerous studies have documented these risks, the link between individual agents and intra-operative cardiac arrest demands ongoing scrutiny if anesthesia care is to become safer. Clarifying such connections will, in turn, support the creation of research-driven protocols that protect patients and strengthen overall surgical outcomes.The present study sets out to chart the rate of intra-operative cardiac arrest across a surgical unit and to explore whether the timing and dosing of propofol were identifiable triggers. To achieve this aim, investigators collected data on patient age, gender and baseline health, documented the specific anesthetic manoeuvres performed during each case and noted pre-operative morbidity known to predispose patients to perioperative events.This study, records from 125 adults booked for elective surgery were reviewed. Information extracted included demographic features, American Society of Anesthesiologists (ASA) grade, type and rate of anesthesia administered, total duration of the procedure, relevant co-morbidity (eg, diabetes, hypertension) and episodes of in-theatre cardiac arrest. Final statistical tests estimated whether propofol, delivered early, mid or late in the procedure, was independently associated with observable collapse of cardiac function during surgery.The study sample was largely young and healthy, with 70.4 percent of the 126 patients being men aged between 26 and 35 years and 80.8 percent assigned ASA Class I. Spinal anesthesia was given to 52 patients and general anesthesia to 48. Intra-operative cardiac arrest was recorded in four subjects, a rate of 3.2 percent, and interestingly every case took place during or right after propofol administration.This strong temporal link points to an unsettling association between propofol and severe cardiac events on the operating table, underlining the need for closer monitoring when the drug is used. Consequently, the results endorse the adoption of site-specific protocols that set limits on bolus doses, mandate real-time assessment of cardiac function, and consider alternative agents to reduce the risk of peri-operative arrhythmias and drops.
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Alam et al. (2026) conducted a cross-sectional in Elective surgery requiring anesthesia (n=125). Propofol administration vs. No propofol administration was evaluated on Intra-operative cardiac arrest. Intra-operative cardiac arrest occurred in 3.2% of elective surgery patients (4 out of 125), with all events coinciding directly with or immediately following the administration of propofol.
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