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Do Patients With Mental Illness Undergoing Office-Based Sedation Require an Increased Propofol Dosage?
Jaehee Hong1, Reese R Triana2, Tareq Ferdous Khan3
1Former Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Cincinnati, Cincinnati, OH.
Summary
Patients with mental illness may require higher propofol doses for adequate anesthesia. This retrospective study found a statistically significant association between mental illness and increased propofol dosage after adjusting for covariates.
Area of Science:
- Anesthesiology
- Psychiatry
- Pharmacology
Background:
- Providers report increased sedative requirements for patients with mental illnesses.
- Previous claims regarding sedative doses in patients with mental illnesses lack thorough assessment.
Purpose of the Study:
- To quantify the association between mental illness and propofol dosage for achieving adequate anesthesia.
- To investigate the impact of mental illness on sedative requirements during surgical procedures.
Main Methods:
- Retrospective cohort study of 409 patients undergoing oral and maxillofacial surgery.
- Propofol dosage (mg/kg/min) and Richmond Agitation-Sedation Scale (RASS) scores were primary outcomes.
- Bivariate and multivariable regression analyses were employed, controlling for covariates such as sex, age, and other drug use.
Main Results:
- Bivariate analysis showed no significant association between mental illness and propofol dose or RASS score.
- Multivariable analysis, after adjusting for covariates, revealed a statistically significant association between mental illness and increased propofol dose (P < .01).
- Sex was the only covariate significantly associated with RASS scores (P < .05) after adjustment.
Conclusions:
- Mental illness is associated with a higher requirement for propofol dosage to achieve satisfactory anesthesia.
- These findings suggest that mental health status is a relevant factor in anesthetic management.
- Further research is warranted to explore the mechanisms underlying altered sedative requirements in patients with mental illness.
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