Thorsten Brechmann1, Christoph Maier2, Miriam Kaisler2, Jan Vollert2, Wolff Schmiegel1, Svetlana Pak3, Norbert Scherbaum4, Fred Rist5, Andrea Riphaus3. 1. 1Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Ruhr-University Bochum, Department of Gastroenterology and Hepatology, Germany. 2. 2Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Ruhr-University Bochum, Department of Pain Medicine, Germany. 3. 3KRH Klinikum Agnes Karll Laatzen, Department of Internal Medicine and Gastroenterology, Laatzen, Germany. 4. LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany. 5. University of Münster, Department of Psychology, Münster, Germany.
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, χ2 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).
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, χ2 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).
Authors: Jean-Marc Dumonceau; Andrea Riphaus; Florian Schreiber; Peter Vilmann; Ulrike Beilenhoff; Jose R Aparicio; John J Vargo; Maria Manolaraki; Caroline Wientjes; István Rácz; Cesare Hassan; Gregorios Paspatis Journal: Endoscopy Date: 2015-11-12 Impact factor: 10.093
Authors: A Riphaus; T Wehrmann; J Hausmann; B Weber; S von Delius; M Jung; P Tonner; J Arnold; A Behrens; U Beilenhoff; H Bitter; D Domagk; S In der Smitten; B Kallinowski; A Meining; A Schaible; D Schilling; H Seifert; F Wappler; I Kopp Journal: Z Gastroenterol Date: 2016-01-11 Impact factor: 2.000
Authors: Douglas K Rex; Viju P Deenadayalu; Emely Eid; Thomas F Imperiale; John A Walker; Kuldip Sandhu; Anthony C Clarke; Lybus C Hillman; Akira Horiuchi; Lawrence B Cohen; Ludwig T Heuss; Shajan Peter; Christoph Beglinger; James A Sinnott; Thomas Welton; Magdy Rofail; Iyad Subei; Rodger Sleven; Paul Jordan; John Goff; Patrick D Gerstenberger; Harold Munnings; Martin Tagle; Brian W Sipe; Till Wehrmann; Jack A Di Palma; Kaitlin E Occhipinti; Egidio Barbi; Andrea Riphaus; Stephen T Amann; Gen Tohda; Timothy McClellan; Charles Thueson; John Morse; Nizam Meah Journal: Gastroenterology Date: 2009-06-21 Impact factor: 22.682