Propofol pretreatment induced place preference and self-administration of the tiletamine-zolazepam combination: implication on drug of abuse substitution

A comprehensive analysis of propofol abuse, addiction and neuropharmacological aspects: an updated review

This review aims to assess the existing studies on propofol, a relatively new intravenous anesthetic, related to its abuse and addictive potential and to explain the neurobiological and neuropharmacological aspects of propofol addiction. Several neurobiological factors related to complex processes in the brain influence propofol abuse and addiction. In this review, we assessed the literature regarding propofol abuse and addiction, including both experimental and clinical studies. We selected articles from animal studies, case reports, clinical trials, meta-analyses, narrative reviews, and systematic reviews to extract all relevant crucial quantitative data with a measure of neurobiological and neuropharmacological aspects. Thus, the main goal of this study was to investigate the current literature and discuss the association between the central nervous system and propofol abuse and addiction in the context of addictive behavior. Current data suggest that propofol has a strong addictive potential and produces prominent addiction in both animals and humans. Thus, medical practitioners should exercise caution with propofol use, and we argue that this drug should be added to the list of controlled substances.

Regulatory Effects of Propofol on High-Dose Remifentanil-Induced Hyperalgesia

We aimed to evaluate the regulatory effects of propofol on high-dose remifentanil-induced hyperalgesia. A total of 180 patients receiving laparoscopic cholecystectomy were randomly divided into sevoflurane + high-dose remifentanil (SH) group, sevoflurane + low-dose remifentanil (SL) group and propofol + high-dose remifentanil group (PH) group (n=60). After intravenous administration of midazolam, SH and SL groups were induced with sevoflurane and remifentanil, and PH group was induced with propofol and remifentanil. During anesthesia maintenance, SH and SL groups were given 0.3 μg/kg/min and 0.1 μg/kg/min sevoflurane and remifentanil respectively, and PH group was given 0.3 μg/kg/min propofol and remifentanil. The three groups had significantly different awakening time, extubation time and total dose of remifentanil (P<0.001). Compared with SL group, periumbilical mechanical pain thresholds 6 h and 24 h after surgery significantly decreased in SH group (P<0.05), and the visual analog scale (VAS) scores significantly increased 30 min, 2 h and 6 h after surgery (P<0.05). Compared with SH group, periumbilical mechanical thresholds 6 h and 24 h after surgery were significantly higher in PH group (P<0.05), and VAS scores 30 min, 2 h and 6 h after surgery were significantly lower (P<0.05). PH group first used patient-controlled intravenous analgesia pump significantly later than SL group did (P<0.05). The total consumptions of sufentanil in PH and SL groups were significantly lower than that of SH group (P<0.05). The incidence rates of bradycardia and postoperative chill in PH and SH groups were significantly higher than those of SL group (P<0.05). Anesthesia by infusion of high-dose remifentanil plus sevoflurane caused postoperative hyperalgesia which was relieved through intravenous anesthesia with propofol.