The Relationship Between Age and the Propofol Dose for Anesthesia Induction: A Single-Center Retrospective Study Utilizing Neural Network Model Simulation

Propofol is commonly used for anesthetic induction, but its dose-dependent hypotensive effect remains a concern. Although the required dose for loss of consciousness decreases with age, the optimal induction dose in older individuals is not well established. This retrospective study aimed to construct a neural network model to predict the propofol induction dose and to quantify the relationship between age and the propofol induction dose through model-based simulations. We analyzed data from 405 patients who underwent elective non-cardiac surgery. A multilayer perceptron model (“model N”) was developed to predict the required induction dose based on clinical parameters. Its predictive performance was compared with that of “model P”, a previously published regression equation derived from multivariable analysis, using the RMSE and MAE. Model N showed significantly better accuracy than model P (RMSE: 17.6 vs. 25.8; MAE: 13.0 vs. 16.7; p < 0.001). Simulation utilizing model N revealed that the induction dose of propofol per body weight decreased by approximately 0.1 mg/kg for every 10-year increase in age. These findings suggest that our proposed model may help determine more accurate and safer dosing strategies for elderly patients undergoing general anesthesia.