# Selective impairment and a positive recognition bias of the facial emotion recognition after propofol anesthesia during gastrointestinal endoscopy

## TL;DR

This study finds that propofol anesthesia during endoscopy impairs the ability to recognize anger in facial expressions, while leaving other emotions and decision-making abilities largely unaffected.

## Contribution

The study reveals a selective impairment in anger facial emotion recognition after propofol anesthesia, along with a positive recognition bias for anger and neutral expressions.

## Key findings

- Propofol anesthesia selectively impairs anger facial emotion recognition post-procedure.
- Patients showed a positive bias, mistaking anger and neutral expressions for happiness.
- Morning procedures and absence of insomnia were linked to decreased anger recognition scores.

## Abstract

Propofol may induce emotional impairment like euphoria and elation. Previous studies have demonstrated that emotional impairment can injure social cognition like emotion recognition and decision-making abilities. Therefore, this study is designed to investigate the effects of propofol anesthesia on facial emotion recognition (FER) and delay discounting behavior.

Patients underwent diagnostic gastrointestinal endoscopy (GI) with propofol anesthesia in this prospective cohort observational study. Prior to and following the procedure (approximately 30 min afterwards), patients were asked to select the word that best describes the presented facial photographs displaying happiness, anger, and neutral expressions. Additionally, Monetary Choice Questionnaire-9 was used to assess delay discounting.

Within a cohort of 87 patients, 11 patients (12.6%) met the criterion of FER deficit post-GI. The FER of anger exhibited significant differences between pre- and post-GI, considering both the correct (52.6%) and incorrect (24.3%) recognition. There was a positive identification bias for FER after propofol anesthesia: mistaking anger (p = 0.02) or neutral (p = 0.01) expression for happiness. Procedures in the morning and the absence of insomnia were associated with the decreased FER score of anger post-GI. The results did not indicate any impairment of propofol anesthesia on FER of happiness or delay discounting behavior.

The study demonstrates that propofol anesthesia during GI endoscopy selectively impairs the recognition of anger facial expressions while leaving the recognition of happiness and delay discounting unaffected at a short-term postoperative observation. Additionally, the recognition of anger and neutral facial expressions exhibited a tendency towards a positive bias.

https://www.chictr.org.cn/showproj.html?proj=199458, identifier ChiCTR2300073132.