Propofol is widely used as a short-acting intravenous anaesthetic for the induction and maintenance of anaesthetic sedation. The application of propofol is expanding due to its advantages and the increasing demand for painless diagnosis and treatment. However, accumulating clinical and experimental evidence has shown that propofol can potentially be abused and is prone to causing addiction. To further understand the underlying mechanism of propofol addiction, our review places emphasis on explaining the roles of the mesolimbic, noradrenergic, and nitrergic systems in propofol addiction. We have focused on the role of the gamma-aminobutyric acid, glucocorticoid, N-methyl-D-aspartic acid, adenosine A2A, and corticotropin-releasing factor receptors in the mesolimbic system in forming and maintaining propofol addiction. Furthermore, we have attempted to clarify the relationship between the dopaminergic pathway, extracellular signal-regulated kinase signalling pathway, and the ventral tegmental area-nucleus accumbens circuit in the mesolimbic system.

Key Policy Highlights

1. Although propofol is effective in inducing and maintaining anesthesia, it is prone to cause abuse and addiction.

2. The mesolimbic, noradrenergic, and nitrergic systems are involved in propofol addiction.

3. The dopaminergic pathway, extracellular signal-regulated kinase signalling pathway, and the ventral tegmental area-nucleus accumbens circuit in the mesolimbic system may be involved in the maintenance of propofol addiction.

中文翻译：

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异丙酚成瘾机制回顾

异丙酚广泛用作短效静脉内麻醉剂，用于诱导和维持麻醉镇静。异丙酚的应用由于其优势和无痛诊疗需求的增加而不断扩大。然而，越来越多的临床和实验证据表明，异丙酚存在被滥用的潜在风险，并且容易导致成瘾。为了进一步了解异丙酚成瘾的潜在机制，我们的综述着重于解释中脑边缘、去甲肾上腺素能和氮能系统在异丙酚成瘾中的作用。我们专注于中脑边缘系统中 γ-氨基丁酸、糖皮质激素、N-甲基-D-天冬氨酸、腺苷 A2A 和促肾上腺皮质激素释放因子受体在形成和维持异丙酚成瘾中的作用。此外，

主要政策亮点

1. 异丙酚虽然能有效诱导和维持麻醉，但容易引起滥用和成瘾。

2. 中脑边缘系统、去甲肾上腺素能系统和氮能系统与异丙酚成瘾有关。

3. 中脑边缘系统中的多巴胺能通路、细胞外信号调节激酶信号通路和腹侧被盖区-伏隔核回路可能参与异丙酚成瘾的维持。