Prurigo Reduces Propofol Requirement under General Anesthesia

Abstract

Studies, including fMRI, show that neurodegeneration or a decrease in neuron count occurs in certain brain regions of patients with chronic itchy lesions. In these studies attention was also drawn to increased GABAA receptor sensitivity. In 3 patients suffering from chronic stress-induced non-histaminergic pruritus for more than 6 weeks, who underwent elective orthopedic surgery under total intravenous general anesthesia with bispectral index monitoring, it has been determined that total propofol consumption was 50, 78 and 58 micrograms/kg/min respectively. All three operations lasted more than 2 hours, were completed without any complications or awareness and all 3 patients were hemodynamically stable among the operation. From this point of view, we observed that GABA receptor sensitivity increased in patients with chronic itching. Also the need for propofol during general anesthesia, which acts on GABA receptors, decreased to doses equivalent to average sedation doses. We consider that administering drugs acting on these receptors at optimum doses (using EEG-based monitoring) is important for patient safety especially in patients with chronic itching.