Top 50 cited articles on propofol use in anesthesia induction: efficacy, safety, and innovations: bibliometric analysis

<p><strong>Background: </strong>Propofol is a key component of contemporary anaesthesia due to its rapid onset and recovery. Despite decades of research, the fundamental studies shaping its clinical use have never been fully mapped. This study provides a citation-based landscape by identifying and analysing the top 50 most cited articles on propofol use in anaesthetic induction, highlighting key developments, topics, and influential authors.</p> <p><strong>Methods:</strong> We performed a bibliometric analysis using the Web of Science with the keywords &ldquo;propofol&rdquo; and &ldquo;anaesthesia,&rdquo; without year restrictions. Articles were screened for relevance focusing on efficacy, safety, and innovations. The top 50 articles by citation count were selected. Data on citations, publication metrics, geographic origin, study design, and level of evidence were extracted and analysed descriptively.</p> <p><strong>Results:</strong> The 50 papers totaled 5,252 citations (mean: 104.1; h-index: 50). The top 10% accounted for 40% of citations, largely from European research. Randomized controlled trials comprised 46%, establishing basic safety, effectiveness, and dosage data, while only 8% were systematic reviews/meta-analyses, highlighting a notable gap. Temporal analysis revealed three eras: 1990s (efficacy and antiemetic properties), 2000s (opioid interactions), and 2010&ndash;2020 (pharmacokinetic-pharmacodynamic modeling for precision dosage). Geographically, 66% of articles originated in Europe, raising concerns about applicability.</p> <p><strong>Conclusion:</strong> This bibliometric analysis confirms propofol&rsquo;s central role in anesthesia induction. Despite strong clinical evidence, the field lacks comprehensive data synthesis and regional diversity, limiting global guideline applicability. Future research should prioritize multinational collaborations and high-quality systematic reviews to develop safer, widely applicable induction practices for diverse patient populations.</p>