[A patient with drug abuse who developed multiple psychotic symptoms during sedation with propofol]

We report a patient with drug abuse who developed multiple psychotic symptoms including euphoria, excitement, hallucination and delirium during sedation with propofol under spinal anesthesia. A 37-year-old man who had abused methamphetamines, thinner, phychomimetics and alcohol for 20 years was scheduled for skin transplant as day-case surgery. He was treated with cholorpromazine, haloperidol and flunitrazepam just before the surgery. Sedation with propofol under spinal anesthesia was thought to be suitable in order to prevent psychotic symptoms. After spinal anesthesia, propofol 5 mg.kg-1.h-1 was administered intravenously as sedation. However, euphoria and excitement appeared 10 min after the start of infusion. He also demonstrated excitement, hallucination and delirium under propofol 6-8 mg.kg-1.h-1. His symptoms were suppressed by intravenous injection of haloperidol 5 mg. We speculate that propofol may produce psychotic symptoms when it is used in patients with a history of drug abuse.