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Preoperative Anxiety's Impact on the Median Effective Dose of Esketamine for Alleviating Propofol Injection Pain in Patients Undergoing Painless abortion: A Randomized, Double-Blind, Controlled Trial
Propofol injection pain (PIP) is a frequent adverse effect during anesthesia induction, impacting patient comfort and satisfaction. Esketamine has been shown to alleviate PIP, but the optimal dose, especially in relation to preoperative anxiety levels, remains unclear. Preoperative anxiety may heigh...
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| Published in: | Drug design, development and therapy development and therapy, 2024-01, Vol.18, p.5863-5872 |
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| creator | Shen, Yanping Yin, Lijun Hu, Binnan Xia, Yilun Zhang, Liangguang |
| description | Propofol injection pain (PIP) is a frequent adverse effect during anesthesia induction, impacting patient comfort and satisfaction. Esketamine has been shown to alleviate PIP, but the optimal dose, especially in relation to preoperative anxiety levels, remains unclear. Preoperative anxiety may heighten pain perception and influence analgesic requirements.
A randomized, double-blind, controlled trial was conducted at The Affiliated Women and Children's Hospital of Ningbo University. A total of 150 eligible patients scheduled for painless abortion were assessed using the Spielberger State Anxiety Inventory - State form (STAI-S) and categorized into non-anxious (STAI-S score |
| doi_str_mv | 10.2147/DDDT.S482019 |
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A randomized, double-blind, controlled trial was conducted at The Affiliated Women and Children's Hospital of Ningbo University. A total of 150 eligible patients scheduled for painless abortion were assessed using the Spielberger State Anxiety Inventory - State form (STAI-S) and categorized into non-anxious (STAI-S score <40) and anxious (STAI-S score ≥40) groups. Patients were randomized using a computer-generated random number table to receive one of five escalating doses of esketamine (0.10, 0.12, 0.14, 0.17, or 0.20 mg/kg) prior to propofol administration. The primary outcome was the occurrence of PIP, assessed using Ambesh's four-point pain scale. Secondary outcomes included hemodynamic parameters and adverse events such as hypotension, bradycardia, and hypoxemia.
A clear dose-response relationship was observed, with higher doses of esketamine significantly reducing the incidence of PIP in both groups. Anxious patients required higher doses of esketamine to achieve comparable pain relief to non-anxious patients. The effective dose for 50% of patients (ED
) in the non-anxious group was 0.114 mg/kg (95% CI: 0.096-0.129 mg/kg), whereas it was 0.133 mg/kg (95% CI: 0.117-0.146 mg/kg) in the anxious group, with the difference being statistically significant (
< 0.05). No significant differences were observed between groups in terms of adverse events or hemodynamic stability.
Preoperative anxiety significantly increases the ED
of esketamine required to alleviate propofol injection pain in patients undergoing painless abortion. Anxious patients require higher doses of esketamine to achieve effective analgesia. Individualizing esketamine dosing based on preoperative anxiety levels may enhance patient comfort and optimize pain management during anesthesia.</description><identifier>ISSN: 1177-8881</identifier><identifier>EISSN: 1177-8881</identifier><identifier>DOI: 10.2147/DDDT.S482019</identifier><identifier>PMID: 39670280</identifier><language>eng</language><publisher>New Zealand: Taylor & Francis Ltd</publisher><subject>Abortion ; Abortion, Induced - adverse effects ; Adult ; Adverse events ; Analgesia ; Analgesics ; Analgesics - administration & dosage ; Analgesics - adverse effects ; Anesthesia ; Anxiety ; Anxiety - drug therapy ; Blood pressure ; Bradycardia ; Clinical Trial Report ; Dosage ; dose-response ; Dose-Response Relationship, Drug ; Double-Blind Method ; Drug dosages ; esketamine ; Female ; General anesthesia ; Heart rate ; Hemodynamics ; Humans ; Hypotension ; Hypoxemia ; Injection ; Ketamine ; Ketamine - administration & dosage ; Ketamine - adverse effects ; Narcotics ; Optimization ; Pain ; Pain - drug therapy ; Pain perception ; painless abortion ; Patients ; Pregnancy ; preoperative anxiety ; Propofol ; Propofol - administration & dosage ; Propofol - adverse effects ; propofol injection pain ; Pulse oximetry ; Random numbers ; Statistical analysis ; Surgery ; Young Adult</subject><ispartof>Drug design, development and therapy, 2024-01, Vol.18, p.5863-5872</ispartof><rights>2024 Shen et al.</rights><rights>2024. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Shen et al. 2024 Shen et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c366t-c8ffdd41fc8f6a346a951f6e191599ba90158e38326a0b0bf79e1939ae31b6ac3</cites><orcidid>0000-0002-3678-7197</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3145728731/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3145728731?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25731,27901,27902,36989,36990,44566,53766,53768,74869</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39670280$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shen, Yanping</creatorcontrib><creatorcontrib>Yin, Lijun</creatorcontrib><creatorcontrib>Hu, Binnan</creatorcontrib><creatorcontrib>Xia, Yilun</creatorcontrib><creatorcontrib>Zhang, Liangguang</creatorcontrib><title>Preoperative Anxiety's Impact on the Median Effective Dose of Esketamine for Alleviating Propofol Injection Pain in Patients Undergoing Painless abortion: A Randomized, Double-Blind, Controlled Trial</title><title>Drug design, development and therapy</title><addtitle>Drug Des Devel Ther</addtitle><description>Propofol injection pain (PIP) is a frequent adverse effect during anesthesia induction, impacting patient comfort and satisfaction. Esketamine has been shown to alleviate PIP, but the optimal dose, especially in relation to preoperative anxiety levels, remains unclear. Preoperative anxiety may heighten pain perception and influence analgesic requirements.
A randomized, double-blind, controlled trial was conducted at The Affiliated Women and Children's Hospital of Ningbo University. A total of 150 eligible patients scheduled for painless abortion were assessed using the Spielberger State Anxiety Inventory - State form (STAI-S) and categorized into non-anxious (STAI-S score <40) and anxious (STAI-S score ≥40) groups. Patients were randomized using a computer-generated random number table to receive one of five escalating doses of esketamine (0.10, 0.12, 0.14, 0.17, or 0.20 mg/kg) prior to propofol administration. The primary outcome was the occurrence of PIP, assessed using Ambesh's four-point pain scale. Secondary outcomes included hemodynamic parameters and adverse events such as hypotension, bradycardia, and hypoxemia.
A clear dose-response relationship was observed, with higher doses of esketamine significantly reducing the incidence of PIP in both groups. Anxious patients required higher doses of esketamine to achieve comparable pain relief to non-anxious patients. The effective dose for 50% of patients (ED
) in the non-anxious group was 0.114 mg/kg (95% CI: 0.096-0.129 mg/kg), whereas it was 0.133 mg/kg (95% CI: 0.117-0.146 mg/kg) in the anxious group, with the difference being statistically significant (
< 0.05). No significant differences were observed between groups in terms of adverse events or hemodynamic stability.
Preoperative anxiety significantly increases the ED
of esketamine required to alleviate propofol injection pain in patients undergoing painless abortion. Anxious patients require higher doses of esketamine to achieve effective analgesia. Individualizing esketamine dosing based on preoperative anxiety levels may enhance patient comfort and optimize pain management during anesthesia.</description><subject>Abortion</subject><subject>Abortion, Induced - adverse effects</subject><subject>Adult</subject><subject>Adverse events</subject><subject>Analgesia</subject><subject>Analgesics</subject><subject>Analgesics - administration & dosage</subject><subject>Analgesics - adverse effects</subject><subject>Anesthesia</subject><subject>Anxiety</subject><subject>Anxiety - drug therapy</subject><subject>Blood pressure</subject><subject>Bradycardia</subject><subject>Clinical Trial Report</subject><subject>Dosage</subject><subject>dose-response</subject><subject>Dose-Response Relationship, Drug</subject><subject>Double-Blind Method</subject><subject>Drug dosages</subject><subject>esketamine</subject><subject>Female</subject><subject>General anesthesia</subject><subject>Heart rate</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hypotension</subject><subject>Hypoxemia</subject><subject>Injection</subject><subject>Ketamine</subject><subject>Ketamine - administration & dosage</subject><subject>Ketamine - adverse effects</subject><subject>Narcotics</subject><subject>Optimization</subject><subject>Pain</subject><subject>Pain - drug therapy</subject><subject>Pain perception</subject><subject>painless abortion</subject><subject>Patients</subject><subject>Pregnancy</subject><subject>preoperative anxiety</subject><subject>Propofol</subject><subject>Propofol - administration & dosage</subject><subject>Propofol - adverse effects</subject><subject>propofol injection pain</subject><subject>Pulse oximetry</subject><subject>Random numbers</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Young Adult</subject><issn>1177-8881</issn><issn>1177-8881</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNpdksFuEzEQhlcIREvgxhlZ4gCHptjrXe-6FxSSAJGKiCA9W971OHXw2sHeVJQX5LXwJqFquXhsz-d_xqM_y14SfJ6Tono3m81W59-LOseEP8pOCamqcV3X5PG9_Un2LMYNxoyyHD_NTihnFc5rfJr9WQbwWwiyNzeAJu6Xgf72TUSLbivbHnmH-mtAX0AZ6dBca2j34MxHQF6jefwBveyMA6R9QBNr4cYkLbdGy-C3XnuLFm4zvEpSS2kcMkPsDbg-oiunIKz9Hk85CzEi2fgw0Bdogr5Jp3xnfoM6SyV3jYXxB2tcOk2964NP5RRaBSPt8-yJljbCi2McZVcf56vp5_Hl10-L6eRy3FLG-nFba61UQXTaMEkLJnlJNAPCScl5IzkmZQ20pjmTuMGNrnjKUS6BkobJlo6yxUFXebkR22A6GW6Fl0bsL3xYC5naby2IvGCq0lCoJi1lXkrFgROiCtpKRlKVUfb-oLXdNR2oNo0kSPtA9GHGmWux9jeCEEZLwkhSeHtUCP7nDmIvOhNbsFY68LsoKCkYY5zgMqGv_0M3fhdcmtVAlVVeV3QQPDtQbfAxBtB33RAsBruJwW7iaLeEv7r_gzv4n7_oX31I1As</recordid><startdate>20240101</startdate><enddate>20240101</enddate><creator>Shen, Yanping</creator><creator>Yin, Lijun</creator><creator>Hu, Binnan</creator><creator>Xia, Yilun</creator><creator>Zhang, Liangguang</creator><general>Taylor & Francis Ltd</general><general>Dove</general><general>Dove Medical Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7XB</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>KB0</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-3678-7197</orcidid></search><sort><creationdate>20240101</creationdate><title>Preoperative Anxiety's Impact on the Median Effective Dose of Esketamine for Alleviating Propofol Injection Pain in Patients Undergoing Painless abortion: A Randomized, Double-Blind, Controlled Trial</title><author>Shen, Yanping ; Yin, Lijun ; Hu, Binnan ; Xia, Yilun ; Zhang, Liangguang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c366t-c8ffdd41fc8f6a346a951f6e191599ba90158e38326a0b0bf79e1939ae31b6ac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abortion</topic><topic>Abortion, Induced - adverse effects</topic><topic>Adult</topic><topic>Adverse events</topic><topic>Analgesia</topic><topic>Analgesics</topic><topic>Analgesics - administration & dosage</topic><topic>Analgesics - adverse effects</topic><topic>Anesthesia</topic><topic>Anxiety</topic><topic>Anxiety - drug therapy</topic><topic>Blood pressure</topic><topic>Bradycardia</topic><topic>Clinical Trial Report</topic><topic>Dosage</topic><topic>dose-response</topic><topic>Dose-Response Relationship, Drug</topic><topic>Double-Blind Method</topic><topic>Drug dosages</topic><topic>esketamine</topic><topic>Female</topic><topic>General anesthesia</topic><topic>Heart rate</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Hypotension</topic><topic>Hypoxemia</topic><topic>Injection</topic><topic>Ketamine</topic><topic>Ketamine - administration & dosage</topic><topic>Ketamine - adverse effects</topic><topic>Narcotics</topic><topic>Optimization</topic><topic>Pain</topic><topic>Pain - drug therapy</topic><topic>Pain perception</topic><topic>painless abortion</topic><topic>Patients</topic><topic>Pregnancy</topic><topic>preoperative anxiety</topic><topic>Propofol</topic><topic>Propofol - administration & dosage</topic><topic>Propofol - adverse effects</topic><topic>propofol injection pain</topic><topic>Pulse oximetry</topic><topic>Random numbers</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shen, Yanping</creatorcontrib><creatorcontrib>Yin, Lijun</creatorcontrib><creatorcontrib>Hu, Binnan</creatorcontrib><creatorcontrib>Xia, Yilun</creatorcontrib><creatorcontrib>Zhang, Liangguang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Drug design, development and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shen, Yanping</au><au>Yin, Lijun</au><au>Hu, Binnan</au><au>Xia, Yilun</au><au>Zhang, Liangguang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative Anxiety's Impact on the Median Effective Dose of Esketamine for Alleviating Propofol Injection Pain in Patients Undergoing Painless abortion: A Randomized, Double-Blind, Controlled Trial</atitle><jtitle>Drug design, development and therapy</jtitle><addtitle>Drug Des Devel Ther</addtitle><date>2024-01-01</date><risdate>2024</risdate><volume>18</volume><spage>5863</spage><epage>5872</epage><pages>5863-5872</pages><issn>1177-8881</issn><eissn>1177-8881</eissn><abstract>Propofol injection pain (PIP) is a frequent adverse effect during anesthesia induction, impacting patient comfort and satisfaction. Esketamine has been shown to alleviate PIP, but the optimal dose, especially in relation to preoperative anxiety levels, remains unclear. Preoperative anxiety may heighten pain perception and influence analgesic requirements.
A randomized, double-blind, controlled trial was conducted at The Affiliated Women and Children's Hospital of Ningbo University. A total of 150 eligible patients scheduled for painless abortion were assessed using the Spielberger State Anxiety Inventory - State form (STAI-S) and categorized into non-anxious (STAI-S score <40) and anxious (STAI-S score ≥40) groups. Patients were randomized using a computer-generated random number table to receive one of five escalating doses of esketamine (0.10, 0.12, 0.14, 0.17, or 0.20 mg/kg) prior to propofol administration. The primary outcome was the occurrence of PIP, assessed using Ambesh's four-point pain scale. Secondary outcomes included hemodynamic parameters and adverse events such as hypotension, bradycardia, and hypoxemia.
A clear dose-response relationship was observed, with higher doses of esketamine significantly reducing the incidence of PIP in both groups. Anxious patients required higher doses of esketamine to achieve comparable pain relief to non-anxious patients. The effective dose for 50% of patients (ED
) in the non-anxious group was 0.114 mg/kg (95% CI: 0.096-0.129 mg/kg), whereas it was 0.133 mg/kg (95% CI: 0.117-0.146 mg/kg) in the anxious group, with the difference being statistically significant (
< 0.05). No significant differences were observed between groups in terms of adverse events or hemodynamic stability.
Preoperative anxiety significantly increases the ED
of esketamine required to alleviate propofol injection pain in patients undergoing painless abortion. Anxious patients require higher doses of esketamine to achieve effective analgesia. Individualizing esketamine dosing based on preoperative anxiety levels may enhance patient comfort and optimize pain management during anesthesia.</abstract><cop>New Zealand</cop><pub>Taylor & Francis Ltd</pub><pmid>39670280</pmid><doi>10.2147/DDDT.S482019</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3678-7197</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Publicly Available Content Database; Taylor & Francis Open Access Journals; PubMed Central |
| subjects | Abortion Abortion, Induced - adverse effects Adult Adverse events Analgesia Analgesics Analgesics - administration & dosage Analgesics - adverse effects Anesthesia Anxiety Anxiety - drug therapy Blood pressure Bradycardia Clinical Trial Report Dosage dose-response Dose-Response Relationship, Drug Double-Blind Method Drug dosages esketamine Female General anesthesia Heart rate Hemodynamics Humans Hypotension Hypoxemia Injection Ketamine Ketamine - administration & dosage Ketamine - adverse effects Narcotics Optimization Pain Pain - drug therapy Pain perception painless abortion Patients Pregnancy preoperative anxiety Propofol Propofol - administration & dosage Propofol - adverse effects propofol injection pain Pulse oximetry Random numbers Statistical analysis Surgery Young Adult |
| title | Preoperative Anxiety's Impact on the Median Effective Dose of Esketamine for Alleviating Propofol Injection Pain in Patients Undergoing Painless abortion: A Randomized, Double-Blind, Controlled Trial |
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