Propofol sedation during gastrointestinal endoscopy arouses euphoria in a large subset of patients

Abstract

Background: Propofol is recommended for sedation in gastrointestinal endoscopy (GE), but preliminary data suggest addictive potentials. Objective: The objective of this article is to evaluate the frequency of predominantly euphoric reaction after GE and patients' subsequent reminiscences. Methods: Eighty-two patients undergoing elective GE under propofol sedation were enrolled in a prospective observational study. The grade of anxiety, expectation or relief about the examination's result and affective state in terms of cheerfulness, relaxation, activation, sedation and anxiety were surveyed using a numeric rating scale (1 to 10) immediately before (t1), after GE (t2) and seven days (t3) later. Statistics: hierarchical cluster analysis, heat map, 2 test and paired t test. Results: Mean propofol dosage was 264 AE 120 mg. Two clusters of mood changes emerged (t1 vs. t2). One (n ¼ 46, 56.1%) was characterized by an unease reaction pattern with equal values regarding cheerfulness, relaxation and anxiety, while relaxation decreased; the other cluster showed a euphoric reaction pattern (n ¼ 36, 43.9%) with markedly increased cheerfulness, relaxation and decreased anxiety. These effects intensified at recall (t3). Despite similar endoscopy results, euphoric cluster patients rated these more positively. Conclusion: Propofol induces euphoria in nearly half of the patients undergoing elective GE with persisting, even enhanced reminiscence (germanctr.de, trial number DRKS00011202). KeywordsGastrointestinal endoscopy, propofol sedation, psychotropic effects, addiction Received: 31 July 2017; accepted: 17 September 2017 Key summary 1. Summarize the established knowledge on this subject.. Propofol is recommended for sedation in gastrointestinal endoscopy.. Propofol has shown euphoric reaction patterns and addictive potentials in healthy volunteers. 2. What are the significant and/or new findings of this study?. Propofol induces euphoria in nearly half of the patients undergoing gastrointestinal endoscopy.. The memory of euphoria persists and even enhances over time.

Comparison of the impact of propofol versus sevoflurane on early postoperative recovery in living donors after laparoscopic donor nephrectomy: a prospective randomized controlled study

“…The better recovery outcomes (higher QoR-40 K score and physical capability) observed in the IV propofol group could be explained by differences in characteristics between the two anesthetic agents. First, propofol has anxiolytic effects and produces a general sense of well-being, or even euphoria, after general anesthesia [ 9 , 24 , 25 ]. The anxiolytic effect is related to potentiation of GABA A receptors and inhibition of the serotonergic system, while the euphoric mood is associated with the stimulation of dopaminergic neurons in the ventral tegmental area [ 24 , 26 ].…”

Comparison of the Impact of Propofol and Sevoflurane on Early Postoperative Recovery in Living Donors After Laparoscopic Donor Nephrectomy: A Prospective Randomized Controlled Study

“…The better recovery outcomes (higher QoR-40K score and physical capability) observed in the IV propofol group could be explained by the difference in characteristics between the two anesthetic agents. Firstly, propofol has anxiolytic effects and produces a general sense of well-being, or even euphoria, after general anesthesia (7,22,23). The anxiolytic effect is related to potentiation of GABA A receptors and inhibition of the serotonergic system, while the euphoric mood is associated with the stimulation of dopaminergic neurons in the ventral tegmental area (22,24).…”

Comparison of the impact of propofol versus sevoflurane on early postoperative recovery in living donors after laparoscopic donor nephrectomy: a prospective randomized controlled study

“…The better recovery outcomes (higher QoR-40K score and physical capability) observed in the IV propofol group could be explained by differences in characteristics between the two anesthetic agents. First, propofol has anxiolytic effects and produces a general sense of well-being, or even euphoria, after general anesthesia (9,24,25). The anxiolytic effect is related to potentiation of GABA A receptors and inhibition of the serotonergic system, while the euphoric mood is associated with the stimulation of dopaminergic neurons in the ventral tegmental area (24,26).…”