Propofol addiction: the mechanism issues we need to know

Abstract

Propofol is widely used for anesthesia and sedation due to its rapid onset and short duration of action, rapid metabolism, rapid clearance, and fewer side effects [ 1 ]. Since 1992, propofol, like other addictive substances such as morphine [ 2 ], has been widely reported for its drug addiction and abuse. Drug dependence, also known as drug addiction, is a mental and sometimes physical state caused by the interaction of a drug with the body, manifesting a compulsion to use the drug on a continuous or regular basis and other reactions. Current research suggests that drug abuse activates the brain reward system and that the ventral tegmental area-nucleus accumbens-prefrontal cortex (VTA-NAc-PFC) pathway is a key component of the reward circuitry for propofol addiction at the neural circuit, molecular, and cellular levels [ 3 ]. Animal self-administration (AD) and conditioned positional preference (CPP) are classic models used to study addictive drugs, demonstrating that propofol produces rewarding and reinforcing effects. According to recent literature, propofol is widely abused in the medical professions, especially by anesthesiologists and certified registered nurse anesthetists who have easy access to propofol [ 4 ]. However, in recent years, the studies on the mechanisms of rewarding and reinforcing effects produced by propofol have gradually increased and deepened, and it is necessary to summarize and prospect the studies on the mechanisms of propofol abuse. We will review the receptor mechanisms, neurocircuitry mechanisms, and molecular mechanisms of propofol addiction, and we will prospect the future direction of the research on the basis of the conditions that may induce propofol addiction in the clinic.

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