High trait anxiety was associated with increased propofol requirements for anesthesia induction (2.1 vs 1.8 mg/kg; P=0.01) and maintenance (170 vs 110 μg/kg/min; P=0.02) compared to low trait anxiety.
Cross-Sectional (n=57)
Does high trait anxiety increase propofol dose requirements for induction and maintenance of anesthesia in women undergoing bilateral laparoscopic tubal ligation?
High baseline trait anxiety is an independent predictor of increased intraoperative propofol requirements for induction and maintenance of anesthesia.
Absolute Event Rate: 2.1% vs 1.8%
p-value: p=0.01
The purpose of this study was to determine whether larger doses of anesthetics are required in the anxious patient to establish and maintain a clinically sufficient hypnotic component of the anesthetic state. Fifty-seven women undergoing bilateral laparoscopic tubal ligation with a propofol-based anesthetic regimen were enrolled in this cross-sectional study. Trait (baseline) and state (situational) anxiety were assessed in all patients immediately before surgery, and the propofol doses required for the induction and maintenance of anesthesia were recorded. A bispectral index monitor was used to assure that the hypnotic component of the anesthetic state was the same in all patients. We found that patients with high trait anxiety required more propofol for both the induction (2.1 ± 0.4 vs 1.8 ± 0.3 mg/kg; P = 0.01) and maintenance of anesthesia (170 ± 70 vs 110 ± 20 μg · kg−1 · min−1; P = 0.02), compared with patients with low trait anxiety. State anxiety, however, was not found to affect the propofol doses required for the induction or maintenance of anesthesia. Multiple regression models confirmed that Trait anxiety is an independent predictor for intraoperative propofol requirements (P = 0.02). We conclude that increased baseline (i.e., trait) anxiety is associated with increased intraoperative anesthetic requirements. Thus, we suggest that the initial dose of anesthetic administered by an anesthesiologist should be modified based on the anxiety level exhibited by the patient. Implications The goal of this study was to assess the relationship between preoperative anxiety and intraoperative anesthetic requirements. We found that high baseline anxiety predicts increased intraoperative anesthetic requirements. We suggest that anesthesiologists should modify the initial induction dose based on the anxiety level exhibited by the patient.
Maranets et al. (Wed,) conducted a cross-sectional in Bilateral laparoscopic tubal ligation (n=57). High trait anxiety vs. Low trait anxiety was evaluated on Propofol dose required for induction of anesthesia (mg/kg) (p=0.01). High trait anxiety was associated with increased propofol requirements for anesthesia induction (2.1 vs 1.8 mg/kg; P=0.01) and maintenance (170 vs 110 μg/kg/min; P=0.02) compared to low trait anxiety.