Effects of propofol induction on haemodynamics
Machała, W.; Szebla, R.
Anestezjologia Intensywna Terapia 40(4): 223-226
2008
ISSN/ISBN: 0209-1712 PMID: 19517660 Document Number: 620397
Propofol is probably the most popular intravenous anaesthetic in daily practice. Its use is known to be associated with dose-dependent cardiovascular compromise. We have assessed the effect of a single dose of propofol on cardiovascular function. Eighty-six ASA I and II patients of both sexes, scheduled for elective thoracic cancer surgery, were enrolled to the study. Midazolam 7.5 mg was given as premedication. All patients received epidural or paravertebral catheters one day before the surgery, and a Swan-Ganz catheter before induction. MAP, CO, SVI, PAP, PCWP, SVRI, PVRI, LVSWI, RWSWI and CPP were measured before induction (I) and after administration of 1 mg kg(-1) propofol with 1-3 microg kg(-1) fentanyl, during spontaneous respiration (II). Propofol increased: heart rate (8%), PAP (12%), PVRI (27%), PCWP (27%) and decreased MAP (4.5%), CI (12%), SVI (18%), LVSWI (23%), RVSWI (17%). CPP decreased by 7%. SVRI remained unchanged. The results indicated that 1 mg kg(-1) propofol moderately compromised cardiac contractility and increased afterload on the right ventricle, without significant effect on coronary perfusion pressure. The cardiovascular compromise was clinically insignificant, but caution is required when propofol is administered in larger doses.