Zhao Kaixuan, Yang Ning, Yue Jingli, Han Ying, Wang Xiaoxiao, Kang Ning, Zhang Tianhao, Guo Xiangyang, Xu Mao
Department of Anesthesiology, Peking University Third Hospital, Beijing, China.
Department of Psychiatry and Clinical Psychology, Peking University Sixth Hospital, Beijing, China.
Front Psychiatry. 2023 Apr 27;14:1001626. doi: 10.3389/fpsyt.2023.1001626. eCollection 2023.
The utilization of Propofol, a widely used intravenous sedative or anesthetic, is characterized by its quick onset, predictable control, and fleeting half-life during both general anesthesia and intensive care unit sedation. Recent evidence, however, has highlighted propofol's propensity to induce euphoria, particularly in patients undergoing painless procedures such as gastrointestinal or gastric endoscopy. Given its widespread use in patients undergoing such procedures, this study aims to investigate the clinical evidence and factors that may influence propofol-induced euphoria in these settings.
The Addiction Research Center Inventory-Chinese Version (ARCI-CV) scale was administered to 360 patients undergoing gastric or gastrointestinal endoscopy using propofol as a sedative. Patient characteristics including past medical history, depression, anxiety, alcohol abuse, and sleep disturbance were recorded through history taking and assessment using various questionnaires prior to the examination. The euphoric and sedative statuses were assessed at 30 min and 1 week post-examination.
The experimental results of a survey of 360 patients who underwent gastric or gastrointestinal endoscopy using propofol showed that the mean Morphine-Benzedrine Group (MBG) score before the procedure and after 30 min of the procedure was 4.23 and 8.67, respectively. The mean Pentobarbital-Chlorpromazine-Alcohol Group (PCAG) score before the procedure and after 30 min of the procedure was 3.24 and 6.22, respectively. These results showed that both MBG and PCAG scores increased significantly after the procedure. Certain factors, such as dreaming, propofol dose, duration of anesthesia, and etomidate dose, were all correlated with MBG both at 30 min and 1 week after the examination. In addition, etomidate had an effect of decreasing MBG scores and increasing PCAG scores both at 30 min and 1 week after the examination.
Taken together, propofol may elicit euphoria and potentially contribute to propofol addiction. There are several risk factors for the development of propofol addiction, including dreaming, propofol dose, duration of anesthesia, and etomidate dose. These findings suggest that propofol may have a euphoric effect and may have the potential for drug addiction and abuse.
丙泊酚是一种广泛使用的静脉镇静剂或麻醉剂，在全身麻醉和重症监护病房镇静期间，其特点是起效迅速、控制效果可预测且半衰期短暂。然而，最近的证据突出了丙泊酚诱发欣快感的倾向，尤其是在接受无痛手术（如胃肠或胃镜检查）的患者中。鉴于其在接受此类手术的患者中广泛使用，本研究旨在调查可能影响这些情况下丙泊酚诱发欣快感的临床证据和因素。
对360例接受丙泊酚镇静的胃肠或胃镜检查患者进行成瘾研究中心量表中文版（ARCI-CV）测评。在检查前通过病史采集和使用各种问卷进行评估，记录患者的特征，包括既往病史、抑郁、焦虑、酒精滥用和睡眠障碍。在检查后30分钟和1周时评估欣快和镇静状态。
对360例接受丙泊酚胃肠或胃镜检查患者的调查实验结果显示，术前及术后30分钟的平均吗啡-苯丙胺组（MBG）评分分别为4.23和8.67。术前及术后30分钟的平均戊巴比妥-氯丙嗪-酒精组（PCAG）评分分别为3.24和6.22。这些结果表明，术后MBG和PCAG评分均显著升高。某些因素，如梦、丙泊酚剂量、麻醉持续时间和依托咪酯剂量，在检查后30分钟和1周时均与MBG相关。此外，依托咪酯在检查后30分钟和1周时均有降低MBG评分和升高PCAG评分的作用。
综上所述，丙泊酚可能诱发欣快感，并可能导致丙泊酚成瘾。丙泊酚成瘾的发生有几个危险因素, 包括梦、丙泊酚剂量、麻醉持续时间和依托咪酯剂量。这些发现表明，丙泊酚可能具有欣快作用，并且可能有药物成瘾和滥用的可能性。
