The impact of age on propofol requirement for inducing loss of
consciousness in elderly surgical patients
Abstract
Aims: It is generally accepted that geriatric patients are more
sensitive to propofol than adults; thus, a dose-adjusted propofol is
recommended for these patients during the induction of anesthesia.
However, for patients aged 75 years and over, established guidelines do
not provide dose references for the anesthesiologists. To this end, we
observed 80 surgical patients (female 39, male 41, American Society of
Anesthesiologists physical status score Ⅰ ~ Ⅱ) to access
the appropriate dose of propofol for inducing loss of consciousness
(LOC). Methods: Patients were subdivided into group A (20 patients,
45~64 yr), group B (20 patients, 65~74
yr), group C (20 patients, 75~84 yr), and group D (20
patients, ≥ 85 yr). All patients received propofol (at a rate of 0.3
mg/kg/min) alone for inducing LOC, which was defined by loss of both
eyelash reflex and verbal response. Results: Compared with group A, the
propofol requirement for LOC in Group B, C and D decreased by 14.8%,
25.2% and 38.5%, respectively. Bivariate linear correlation analysis
showed that propofol requirement was negatively correlated with age.
After adjusting for potential confounders, age was still an independent
factor affecting propofol requirement. Conclusion: The propofol
requirement for inducing LOC decreased significantly in elderly
patients. We demonstrated that age was an independent factor impacting
propofol requirement for LOC during the induction of general anesthesia,
implying that the propofol dose for anesthesia induction should be
further reduced in elderly surgical patients, especially those aged 75
years and over.