Dataset Information

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?±?120?mg. Two clusters of mood changes emerged (t1 vs. t2). One (n?=?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?=?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).

SUBMITTER: Brechmann T

PROVIDER: S-EPMC5987275 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Publications

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

Brechmann Thorsten T Maier Christoph C Kaisler Miriam M Vollert Jan J Schmiegel Wolff W Pak Svetlana S Scherbaum Norbert N Rist Fred F Riphaus Andrea A

United European gastroenterology journal 20171004 4

<h4>Background</h4>Propofol is recommended for sedation in gastrointestinal endoscopy (GE), but preliminary data suggest addictive potentials.<h4>Objective</h4>The objective of this article is to evaluate the frequency of predominantly euphoric reaction after GE and patients' subsequent reminiscences.<h4>Methods</h4>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 examinati ...[more]

PMID: 29881609

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Project description:BackgroundThe 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.MethodsThe 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.ResultsThe 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.ConclusionTaken 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.

Project description:BackgroundHypoxia is a very common adverse event that occurs during gastrointestinal endoscopy under sedation, especially in older patients, owing to limited reservation of heart, brain, lung, and other organs. Prolonged or severe hypoxia can cause ischemia of the coronary artery and permanent nervous system damage, and even result in death. Hence, it is imperative to reduce or prevent hypoxia during gastrointestinal endoscopy under sedation in older patients. Although several oxygen delivery methods would reduce hypoxia during this procedure, early detection of respiratory depression and early administration of intervention would be the best method to reduce or even confirm the hypoxia. Capnographic monitoring is reportedly more sensitive for detecting respiratory depression before the onset of hypoxia than the current clinical routine monitoring of pulse oxygen saturation; however, its effect is controversial. Therefore, in this study, we aimed to improve the safety of gastrointestinal endoscopy under sedation in older patients.MethodsA multicenter, randomized, single-blind, two-arm parallel-group, controlled with an active comparator, interventional superiority clinical trial will be conducted to evaluate the impact of an additional capnographic monitoring-based intervention on the incidence of hypoxia in older patients. Patients (n = 1800) scheduled for gastrointestinal endoscopy with propofol sedation will be randomly assigned to either a control or interventional arm, wherein standard or capnographic monitoring is implemented, respectively.DiscussionThis study primarily aims to examine whether an additional capnographic monitoring-based intervention can reduce the incidence of hypoxia in older patients during gastrointestinal endoscopy under propofol and sufentanil sedation. The results of this study may extensively impact gastrointestinal endoscopy under sedation and the development of associated guidelines.Trial registrationClinicalTrials.gov NCT05030870. Registered on September 1, 2021.

Dataset Information

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

Background

Objective

Methods

Results

Conclusion

Publications

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

Similar Datasets

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