Wanting to be with and talk to people (more sociable).Feeling more in control, self-confident.Feeling as if your thinking is extremely clear.Joy (euphoria, or "flash" or "rush") and less inhibition, similar to being drunk.Using amphetamines may cause pleasurable effects such as: It is also called the feel-good brain chemical. Dopamine is a chemical that is involved with mood, thinking, and movement.
Others use them to boost their performance in sports.Īmphetamines also cause the brain to release dopamine. Some people use amphetamines to help them stay awake on the job or to study for a test. As a result, you are more alert and physically active. They make the messages between your brain and body move faster. These findings are consistent with those of Kram et al.Amphetamines are stimulant drugs. The chronic amphetamine users described here, who had not ingested their usual khat dose the day before surgery, did not need increased drug doses of either isoflurane or opioids. In conclusion, acute and chronic amphetamine abuse must be distinguished. 1 Furthermore, Johnston et al 5 demonstrated that amphetamine decreased the minimum alveolar concentration of halothane in dogs 21%. The lower BP in khat chewers, despite similar end-tidal concentrations of isoflurane and lower doses of alfentanil, may be related to a depletion of catecholamine receptor storage, a mechanism that has been suspected in chronic amphetamine abuse. BP indicates blood pressure C, control (BP at arrival in operating room) I, BP just before induction T, tracheal intubation. 02), despite a similar consumption of isoflurane and a decreased administration of opioids. Systolic BP (mean ± standard deviation) was significantly lower in khat users (Mann-Whitney U test: P <. Heart rate, ephedrine use, and time between extubation and first request for analgesics (145 ± 275 vs 65 ± 44 min ) were not significantly different. 09), BP was lower in the khat group ( Figure P <. Although isoflurane consumption (mean end-tidal values) was not different ( P =. During surgery, khat chewers consumed less alfentanil than controls: 1.5 ± 0.2 vs 2.1 ± 0.3 mg ( P <.
Isoflurane end-tidal concentration was adjusted to maintain blood pressure (BP) at ☓0% of its control value and alfentanil boluses to maintain heart rate at ☓0% of the control value.īiometric data, type of surgery, and induction doses were similar in both groups. After endotracheal intubation, anesthesia was maintained with a mixture of oxygen (50%), nitrous oxide (50%), and isoflurane. Induction consisted of alfentanil 0.02 mg/kg, propofol 2.5 mg/kg, and vecuronium. The preanesthetic consultation determined whether 32 consecutive patients undergoing general anesthesia were drug addicted (khat group, N = 14) or not (controls, N = 18). 4 In a work approved by the local ethnic committee of the French military hospital in Djibouti, I observed that the interaction between khat and general anesthesia was not what was commonly believed. There is a popular perception that patients who chronically ingest amphetamine or amphetamine-like drugs will require high doses of anesthetic drugs to achieve adequate analgesia, sedation, and anesthesia. Moreover, “Westerners” are more and more frequently taking care of immigrants from places where khat is legal but abused (like alcohol) and are unfamiliar with khat as a source of amphetamine. This chronic amphetamine abuse is a significant problem not only in these parts of the world where studies are infrequently performed but also in Western countries where similar drugs (ecstasy, methcathinone, or ephedrone) 3 are consumed.
They contain amphetamine alkaloids (cathine and cathinone) that cause adrenergic stimulation responsible for positive inotropic and vasoconstrictive effects. Khat ( Catha edulis) leaves are legally chewed by the inhabitants of the African Horn and Arabia. Studies of anesthesia in amphetamine users are scarce, 1 and the retrospective study by Kram et al 2 reporting that use of cocaine or amphetamines was not predictive of an increased need for analgesia and sedation in trauma patients is of particular interest.Ī few years ago, when I was an anesthetist in Djibouti, I was warned that anesthesia in khat chewers required higher doses of narcotics and hypnotics.