Changes of Serum Lipid Concentration during General Anesthesia with Propofol Using Target Controlled Infusion

Hong, Seong Joon; Kil, Ho Yeong

Abstract

BACKGROUND: Propofol is a widely used hypnotic, however hyperlipidemia is one of the disadvantages caused by its formulation. The aim of this study was to investigate the concentration of total cholesterol, high density lipoprotein (HDL-cholesterol) and triglycerides during general anesthesia with propofol using a target controlled infusion.
METHODS
With Institutional Review Board approval and informed consent, thirty premedicated (atropine 0.5 mg, I.M) adult patients (ASA class I or II, 18 - 55 yrs) scheduled for elective surgery were studied. A TCI of propofol was started at a target concentration of 6.0ng/ml. After intubation with the aid of vecuronium (0.15 mg/kg), anesthesia was maintained with propofol in combination with 67% N2O and 33% O2. Blood was sampled from the median cubital vein for total cholesterol, HDL- cholesterol, and triglycerides at 0, 1, and 2 hours during anesthesia, the end of surgery, and 24, 48, and 72 hours after anesthesia.
RESULTS
At 1 and 2 hours, and the end of surgery, triglyceride concentrations showed a significant increase compared to the control (P < 0.05), however it declined steeply to normal range during the next 24 hours. The total cholesterol and HDL-cholesterol concentrations were within a normal range throughout the study period. There was a correlation between triglyceride concentrations (peak triglyceride concentration-control triglyceride concentration) and amount of infused propofol (Spearman's r = 0.42, P < 0.05).
CONCLUSIONS
Because the infusion of propofol during anesthesia results in a significant increase in triglyceride concentrations, we should consider checking the triglyceride concentrations intermittently in critically ill patients who receive propofol. However, propofol may be safe to healthy patient for general anesthesia.