# Association between preoperative anxiety and ciprofol requirements in women undergoing surgical abortion: a prospective observational study

## TL;DR

This study found that higher preoperative anxiety in women undergoing surgical abortion is modestly linked to increased ciprofol use and longer induction time.

## Contribution

The study is the first to demonstrate a modest association between preoperative anxiety and ciprofol requirements in surgical abortion patients.

## Key findings

- Preoperative anxiety was weakly but significantly associated with total ciprofol dose and induction time.
- Anxiety was also linked to higher baseline heart rate and mean arterial pressure.
- Subgroup analysis showed differences in ciprofol dose and blood pressure across anxiety levels, though pairwise comparisons were not significant.

## Abstract

To investigate the association between preoperative anxiety level and ciprofol consumption in patients undergoing surgical abortion.

A total of 144 patients scheduled for surgical abortion were enrolled and completed both the State–Trait Anxiety Inventory (STAI) and the Self-Rating Anxiety Scale (SAS). Anesthesia was induced with 5 μg/kg alfentanil and 0.3 mg/kg ciprofol. Additional ciprofol (0.1 mg/kg each) was administered as needed to maintain adequate anesthetic depth. The primary outcomes were the total ciprofol dose and State Anxiety (S-STAI) score. Secondary outcomes included the Trait Anxiety (T-STAI) and SAS scores, induction time, awakening time, baseline hemodynamic profiles, and the incidence of adverse events.

Preoperative anxiety levels (S-STAI) were weakly and positively associated with total ciprofol dose (rs = 0.216, 95%CI [0.049, 0.371], p = 0.009), induction time (rs = 0.312, 95%CI [0.1521, 0.4567], p < 0.001), baseline heart rate (HR) (rs = 0.321, 95%CI [0.1611, 0.4640], p < 0.001), and mean arterial pressure (MAP) (rs = 0.213, 95%CI [0.04579, 0.3676], p = 0.011). No significant association was observed between preoperative anxiety and awakening time (rs = −0.156, 95%CI [−0.3163, 0.01239], p = 0.062). Furthermore, after multivariate linear regression analysis considering confounding factors, preoperative anxiety remained a statistically significant, though modest, independent variable associated with total ciprofol dose (β = 0.187, 95%CI [0.089, 0.285]). Subgroup analysis showed a significant overall difference in total ciprofol dose (p = 0.032) and baseline MAP (p = 0.044) across anxiety groups, although pairwise comparisons were not statistically significant. Baseline HR was higher in both moderate and severe anxiety groups, while induction time was longer only in the moderate-anxiety group, compared with the mild-anxiety group. The incidence of adverse events did not differ significantly among the groups (all p > 0.05).

Preoperative anxiety showed a modest association with ciprofol requirements and induction time. These results indicate that anxiety may be a relevant factor to consider during sedation management for surgical abortion.

ChiCTR2500108366 (Chinese Clinical Trial Registry, www.chictr.org.cn).