Chronic Alcoholism and Propofol Demand: The Impact of Alcohol Tolerance in Painless Gastrointestinal Endoscopy.

Background and Aim: Existing research suggests that chronic alcohol consumption may increase propofol requirements during anesthesia, though findings remain inconsistent. This study investigated the influence of chronic ethanol intake and alcoholic tolerance on propofol dosage in patients undergoing painless gastrointestinal endoscopy. Methods: One hundred male patients with habitual alcohol consumption were enrolled. Drinking behavior was assessed using the Alcohol Use Disorders Identification Test (AUDIT), and alcohol tolerance was also assessed by self-reporting. Propofol was infused using a bispectral index (BIS)-guided closed-loop target-controlled infusion system during induction and maintenance of anesthesia. The depth of anesthesia was controlled to maintain a BIS value of 60 ± 5, and the target plasma and effect-site concentrations were recorded throughout the procedure. Results: Patients with high alcohol tolerance, but not hazardous drinking behavior, consumed higher propofol doses and exhibited higher effect-site concentrations during anesthesia induction (BIS reach 60), maintenance (10 min post induction), and recovery (eye-opening under stimuli). Both higher alcohol tolerance and hazardous drinking behavior were associated with shorter recovery times. Conclusions: Propofol requirements are increased in patients with high alcohol tolerance during painless gastrointestinal endoscopy. The mechanisms underlying this association, including potential pharmacodynamic adaptations, warrant further investigation.