Women who feel anxious before pregnancy termination under general anesthesia may need more propofol to fall asleep, but the same does not appear to hold for the newer hypnotic ciprofol, according to a prospective observational cohort study published in BMC Anesthesiology.
The study enrolled women undergoing pregnancy termination under general anesthesia and set out to test whether preoperative anxiety, long associated with increased propofol requirements, similarly affects ciprofol anesthesia.
The primary outcome was the weight-normalized induction dose required to reach a Patient State Index of 50, a processed electroencephalography measure indicating a defined depth of hypnosis. Secondary outcomes included total anesthetic consumption, EEG parameters, perioperative hemodynamics, induction and recovery times, and intraoperative body movements.
A total of 213 patients were analyzed. The researchers observed a significant interaction between APAIS anxiety scores and anesthetic type for induction dose (B = −0.03, P < 0.01), meaning the relationship between anxiety and drug requirement depended on which agent was used.
Higher APAIS scores were correlated with greater propofol induction dose (ρ = 0.22, P = 0.02), but not with ciprofol requirements (ρ = 0.004, P = 0.97). Patients with high anxiety required higher propofol induction doses than those with low anxiety (P = 0.01), whereas ciprofol requirements were comparable between the anxiety groups (P = 0.08).
A similar interaction pattern emerged for total intraoperative anesthetic consumption (B = −0.10, P = 0.02), although within either anesthetic group the anxiety scores were not significantly correlated with total consumption. The authors note this nuance: the interaction was statistically detectable, but the simple correlation between anxiety and total consumption did not reach significance within either drug group.
Processed EEG measures and hemodynamic parameters showed similar overall trends among the four groups, with no significant differences between the high- and low-anxiety subgroups within either anesthetic group. In other words, the anxiety-related difference in dosing did not translate into detectable differences in brain activity monitoring or cardiovascular measures between anxiety strata.
The authors conclude that the association between preoperative anxiety and anesthetic induction dose requirements differed between propofol and ciprofol among women undergoing pregnancy termination. Higher anxiety scores were associated with increased propofol induction doses, whereas no statistically detectable association was observed for ciprofol.
As an observational cohort study, the research documents associations rather than testing a causal intervention, and its findings are specific to women undergoing pregnancy termination under general anesthesia. The study protocol was registered in the Chinese Clinical Trial Registry (ChiCTR2500100973), and the article was published open access on 29 October 2026.
Subject of Research: The association between preoperative anxiety and induction dose requirements for propofol versus ciprofol anesthesia in pregnancy termination.
Article Title: Effects of preoperative anxiety on anesthetic responsiveness to propofol and ciprofol during pregnancy termination: a prospective observational cohort study
Article References: Yang, J., Qiu, L., Zhu, L., Zhang, H., Cai, W., Shen, F., Shi, K., chen, Y., & Sun, J. (2026). Effects of preoperative anxiety on anesthetic responsiveness to propofol and ciprofol during pregnancy termination: a prospective observational cohort study. BMC Anesthesiology. https://doi.org/10.1186/s12871-026-04392-9
Image Credits: AI Generated
DOI: 10.1186/s12871-026-04392-9
Keywords: preoperative anxiety, propofol, ciprofol, pregnancy termination, general anesthesia, APAIS, induction dose, Patient State Index, processed EEG, observational cohort study, anesthetic requirements, BMC Anesthesiology
News Source: Harold Sullivan. (October 29, 2026). Preoperative Anxiety Raises Propofol Needs but Not Ciprofol Doses in Pregnancy Termination Anesthesia. Scienmag.
