Presurgical depressive symptom and anaesthetic requirements in patients undergoing surgery for malignant and...

Area of Science:

• Anesthesiology
• Psychiatry
• Oncology

Background:

• Preanesthetic evaluation rarely assesses depression's incidence and magnitude.
• Shared physiological pathways link depression and anesthetic drugs, potentially affecting propofol pharmacodynamics.
• Understanding presurgical depression is crucial for optimizing anesthetic management.

Purpose of the Study:

• To evaluate the prevalence of presurgical depression.
• To assess the impact of depression on propofol consumption during anesthesia.

Main Methods:

• Prospective, observational, cross-sectional, analytical study.
• Included 174 adult patients undergoing surgery (87 with cancer, 87 without).
• Depressive symptoms assessed using the Patient Health Questionnaire-9 (PHQ-9); propofol requirements recorded.

Main Results:

• Prevalence of depression (PHQ-9 > 4) was 58.6% in cancer patients vs. 18.4% in non-cancer patients.
• Moderate to severe depression (PHQ-9 > 9) was 35.6% in cancer patients vs. 3.4% in non-cancer patients.
• Cancer patients with depression required significantly less propofol (114.7 ± 22.9mg) than those without (126.4 ± 24.3mg; p=0.025).

Conclusions:

• The burden of pre-anesthetic depression is substantial, particularly in cancer patients.
• Presurgical depression is associated with reduced propofol requirements during anesthesia.
• These findings highlight the importance of screening for depression in surgical patients.