Association of socioeconomic status and state anxiety with pain and subjective sensations during propofol injection

Objective: This study aimed to investigate the relationship between pain experienced during propofol injection and patients’ socioeconomic status and state anxiety, while considering the effects of age, sex, body mass index, and time to loss of consciousness. Method: In this prospective, single-center observational study, adult patients undergoing anesthesia induction with propofol were included. Injection pain was evaluated within the first 30 seconds using a 0–10 visual analog scale. In addition, injection-related subjective sensations, including flushing, tingling, dizziness, taste disturbance, tinnitus, and pleasant sensations, were recorded as secondary outcomes. Socioeconomic status was determined using a composite score derived from education and income levels, and state anxiety was assessed with the six-item State–Trait Anxiety Inventory. The relationship between these variables and injection pain was examined using univariable and multivariable linear regression analyses. A sensitivity analysis including state anxiety was also performed. Results: A total of 106 patients were analyzed. In the multivariable analysis, higher body mass index (B = 0.318, 95% CI: 0.163–0.473; p < 0.001), longer time to loss of consciousness (B = 0.184, 95% CI: 0.124–0.244; p < 0.001), and female sex (B = 0.714, 95% CI: 0.110–1.318; p = 0.021) were independently associated with increased injection pain. Although socioeconomic status and state anxiety were associated with pain in the univariable analyses, these associations did not remain significant after adjustment for clinical covariates. Conclusion: The findings suggest that propofol injection pain is predominantly related to biological and procedural factors. After controlling for clinical variables, neither socioeconomic status nor preoperative state anxiety independently predicted the severity of pain.