Abstract
Propofol is an intravenous anaesthetic which is chemically un-related to other iv anaesthetics. Most anaesthetists are now becoming familiar with propofol’s pharmacokinetic and pharm-acodynamic properties. It has proved to be a reliable drug that can be used safely for induction and maintenance of anaesthesia for most surgical procedures and unlike other anaesthetic agents, it can especially be extended into the postoperative setting or intensive care unit for sedation. Propofol’s greatest attributes are its pharmacokinetic properties which result in a rapid, clear emergence and lack of cumulative effects even after prolonged administration. Compared with other iv anaesthetics, the induction dose of propofol has a relatively higher incidence of respiratory depression, short-lived apnoea and blood pressure reduction that may occasionally be marked. Possible mechanisms for the hypotension may relate to (1) its action on peripheral vasculature (vasodilatation), (2) decreased myocardial contractility, 3) resetting of the baroreflex activity and (4) inhibition of the sympathetic nervous system outflow. In vitro studies indicate that propofol depresses the immunological reaction to bacterial challenge as well as the chemotactic activity. Clinical studies, in cardiac surgery, have demonstrated that propofol, in association with an opioid, is a logical anaesthetic choice. Propofol is about to receive approval for continuous iv sedation. Comparative studies of propofol and midazolam have clearly demonstrated the superiority of propofol in terms of rapid recovery and precise control of the level of sedation.
Résumé
Le propofol est un nouvel agent anesthésique iv qui se distingue des autres agents par sa structure chimique. Les anesthésistes sont maintenant familiers avec les propriétés pharmacocinétiques et pharmacodynamiques du propofol. Il s’est révélé efficace et sécuritaire comme agent d’induction et de maintien de l’anesthésie pour diverses procédures chirurgicales. Contrairement aux autres anesthésiques iv, le propofol peut être retenu comme agent de sédation en période postopératoire ou pour faciliter la ventilation mécanique aux soins intensifs. Ses atouts principaux relèvent de ses propriétés pharmacocinétiques qui expliquent sa rapidité d’émergence et l’absence d’accumulation même à la suite d’une administration prolongée. En contrepartie, le propofol occasionne une plus grande incidence de dépression respiratoire, d’apnée et une chute de la tension artérielle qui, occasionnellement, peut être sévère. Les mécanismes probables pour expliquer cette chute de tension sont: 1) la vasodilatation périphérique (diminution des résistances périphériques), 2) la diminution de la contractilité myocardique, 3) un réajustement de l’activité des barorécepteurs et 4) une inhibition du système nerveux sympathique. Une dépression du système immunitaire peut se manifester à la suite d’une infusion prolongée. Des études in vitro suggèrent une dépression de la réponse immunologique ainsi qu’une diminution de la réponse chémotactique des leucocytes. Des études cliniques chez des patients subissant une chirurgie cardiaque ont démontré que le propofol, en association avec un opiacé, est une alternative anesthésique acceptable. Le propofol va recevoir l’approbation pour l’administration intraveineuse continue à visée sédative. Des études comparatives entre le propofol et le midazolam ont démontré la supériorité du propofol en termes de rapidité de récupération de l’anesthésie et du contrôle précis du niveau de sédation.
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Abbreviations
- BRP:
-
Brain retraction pressure
- CI:
-
Cardiac index
- CPB:
-
Cardiopulmonary bypass
- Vc:
-
Central volume
- CSFP:
-
Cerebral spinal fluid pressure
- CPP:
-
Cerebral perfusion pressure
- CBF:
-
Cerebral blood flow
- CVR:
-
Cerebrovascular resistance
- CABG:
-
Coronary artery bypass surgery
- ICU:
-
Intensive care unit
- ICP:
-
Intracranial pressure
- SVR:
-
Systemic vascular resistance
- Vd:
-
Volume of distribution
References
Sebel PS, Lowdon JD. Propofol: a new intravenous anesthetic. Anesthesiology 1989; 71: 260–77.
Langley MS, Heel RC. Propofol. A review of its pharmacodynamic and pharmacokinetic properties and use as an intravenous anaesthetic. Drugs 1988; 35: 334–72.
Cockshott ID. Propofol (Diprivan) pharmacokinetics and metabolism — an overview. Postgrad Med J 1985; 61 (Suppl 3): 45–50.
Gepts E, Camu F, Cockshott ID, Douglas EJ. Disposition of propofol administered as constant rate intravenous infusions in humans. Anesth Analg 1987; 66: 1256–63.
Cockshott ID, Briggs LP, Douglas EJ, White M. Pharmacokinetics of propofol in female patients. Studies using single bolus injections. Br J Anaesth 1987; 59: 1103–10.
Kay NH, Sear JW, Uppington J, Cockshott ID, Douglas EJ. Disposition of propofol in patients undergoing surgery. A comparison in men and women. Br J Anaesth 1986; 58: 1075–9.
Kirkpatrick T, Cockshott ID, Douglas EJ, Nimmo WS. Pharmacokinetics of propofol (Diprivan) in elderly patients. Br J Anaesth 1988; 60: 146–50.
Campbell GA, Morgan DJ, Kumar K, Crankshaw DP Extended blood collection period required to define distribution and elimination kinetics of propofol. Br J Clin Pharmacol 1988; 26: 187–90.
White PR. Propofol: pharmacokinetic and pharmaco-dynamics. Seminars in Anesthesia 1988; 7 (Suppl 1): 4–20.
Servin F, Haberer JP, Cockshott ID, Farinotti R, Desmonts JM. Propofol pharmacokinetics in patients with cirrhosis. Anesthesiology 1986; 65: A554.
Veroli P, O’Kelly B, Bertrand F, Trouvin JH, Farinotti R, Ecoffey C. Extrahepatic metabolism of propofol in man during the anhepatic phase of orthotopic liver transplantation. Br J Anaesth 1992; 68: 183–6.
Morcos WE, Payne JP. The induction of anaesthesia with propofol (Diprivan) compared in normal and renal failure patients. Postgrad Med J 1985; 61 (Suppl 3): 62–3.
Kirvelä M, Olkkola KT, Rosenberg PH, Yli-Hankala A, Salmela K, Lindgren L. Pharmacokinetics of propofol and haemodynamic changes during induction of anaesthesia in uraemic patients. Br J Anaesth 1992; 68: 178–82.
Tauzin-Fin P, Vinçon G, Houdek MC, Demotes-Mainard F, Muscagorry JM. Pharmacocinétique du propofol injecté après hémodilution intentionnelle préopératoire. Ann Fr Anesth Réanim 1991; 10: 337–42.
Stephen CR. Risk factors and outcome in elderly patients: an epidemiologic study.In: Stephen CR, Assaf RAE (Eds.). Geriatric Anesthesia: Priniples and Practice. Boston: Butterworths, 1986: 345–62.
Gill SS, Wright EM, Reilly CS. Pharmacokinetic interaction of propofol and fentanyl: single bolus injection study. Br J Anaesth 1990; 65: 760–5.
Gepts E, Jonckheer K, Maes V, Sonck W, Camu F. Disposition kinetics of propofol during alfentanil anaesthesia. Anaesthesia 1988; 43 (Suppl): 8–13.
Simons PJ, Cockshott ID, Douglas EJ, Gordon EA, Hopkins K, Rowland M. Disposition in male volunteers of a subanaesthetic intravenous dose of an oil in water emulsion of 14C-propofol. Xenobiotica 1988; 18: 429–40.
Schüttler J, Stoeckel H, Schwilden H. Pharmacokinetic and pharmacodynamic modelling of propofol (Diprivan) in volunteers and surgical patients. Postgrad Med J 1985: 61 (Suppl 3): 53–4.
Knell PJW, McKean JF. An investigation of the pharm-acokinetic profile of propofol (Diprivan) after administration for induction and maintenance of anaesthesia by repeat bolus doses in patients having spinal anaesthetic block. Postgrad Med J 1985; 61 (Suppl 3): 60–1.
Shafer A, Doze VA, Shafer SL, White PF. Pharmacokinetics and pharmacodynamics of propofol infusions during general anesthesia. Anesthesiology 1988; 69: 348–56.
Massey NJA, Sherry KM, Oldroyd S, Peacock JE. Pharmacokinetics of an infusion of propofol during cardiac surgery. Br J Anaesth 1990; 65: 475–9.
Russell GN, Wright EL, Fox MA, Douglas EJ, Cockshott ID Propofol-fentanyl anaesthesia for coronary artery surgery and cardiopulmonary bypass. Anaesthesia 1989; 44: 205–8.
Bailie GR, Cockshott ID, Douglas EJ, Bowles BJM. Pharmacokinetics of propofol during and after long term continuous infusion for maintenance of sedation in ICU patients. Br J Anaesth 1992; 68: 486–91.
Albanese J, Martin C, Lacarelle B, Saux P, Durand A, Gouin F. Pharmacokinetics of long-term propofol infusion used for sedation in ICU patients. Anesthesiology 1990; 73: 214–7.
Hughes MA, Glass PAS, Jacobs JR. Context-sensitive half-time in multicompartment pharmacokinetic models for intravenous anesthetic drugs. Anesthesiology 1992; 76: 334–41.
Mackenzie N, Grant IS. Propofol (Diprivan) for continuous intravenous anaesthesia. A comparison with methohexitone. Postgrad Med J 1985; 61 (Suppl 3): 70–5.
Price ML, Millar B, Grounds M, Cashman J. Changes in cardiac index and estimated systemic vascular resistance during induction of anaesthesia with thiopentone, methohexitone, propofol and etomidate. Br J Anaesth 1992; 69: 172–6.
Claeys MA, Gepts E, Camu F. Haemodynamic changes during anaesthesia induced and maintained with propofol. Br J Anaesth 1988; 60: 3–9.
Cartier S, Van Aken H, Vandermeersch E, Thorniley A, Byttebier G. Does nitrous oxide affect the hemodynamic effects of anesthesia induction with propofol? Anesth Analg 1989; 68: 728–33.
Coates DP, Monk CR, Prys- Roberts C, Turtle M. Hemodynamic effects of infusions of the emulsion formulation of propofol during nitrous oxide anesthesia in humans. Anesth Analg 1987; 66: 64–70.
Verborgh C, Verbessen D, Camu F. Haemodynamic effects of isoflurane during propofol anaesthesia. Br J Anaesth 1992; 69; 36–9.
Bentley GN, Gent JP, Goodchild CS. Vascular effects of propofol: smooth muscle relaxation in isolated veins and arteries. J Pharm Pharmacol 1989; 41: 797–8.
Park WK Lynch C, Johns RA. Effects of propofol and thiopental in isolated rat aorta and pulmonary artery. Anesthesiology 1992; 77: 956–63.
Chang KSK, Davis RF. Propofol produces endothelium-independent vasodilation and may act as a Ca2+ channel blocker. Anesth Analg 1993; 76: 24–32.
Rouby JJ, Andreev A, Léger P et al. Peripheral vascular effects of thiopental and propofol in humans with artificial hearts. Anesthesiology 1991; 75: 32–42.
Boer F, Bovill JG, Ros P, Van Ommen H. Effect of thiopentone, etomidate and propofol on systemic vascular resistance during cardiopulmonary bypass. Br J Anaesth 1991; 67: 69–72.
Muzi M, Berens RA, Kampine JP, Eben TJ. Venodilation contributes to propofol-mediated hypotension in humans. Anesth Analg 1992; 74: 877–83.
Ebert TJ, Muzi M, Berens R, Goff D, Kampine JP. Sympathetic responses to induction of anesthesia in humans with propofol or etomidate. Anesthesiology 1992; 76: 725–33.
Van Keer L, Van Aken H, Vandermeersch E, Vermaul G, Lernt T. Propofol does not inhibit hypoxic pulmonary vasoconstriction in humans. Journal of Clinical Anesthesia 1989; 1: 284–8.
Diedericks J, Foëx P, Sear JW, Puttick RM, Ryder WA. Haemodynamic effects of propofol infusion. A dose-response study. Eur J Anaesthesiol 1990; 7: 338–9.
Naeije R, Lejeune P, Leeman M, Melot C, Deloof T. Effects of propofol on pulmonary and systemic arterial pressure-flow relationships in hyperoxic and hypoxic dogs. Br J Anesth 1989; 62: 532–9.
Mulier JP, Wouters PF, Van Aken H, Vermaut G, Vandermeersch E. Cardiodynamic effects of propofol in comparison with thiopental: assessment with a transesophageal echocardiographic approach. Anesth Analg 1991; 72: 28–35.
Gauss A, Heinrich H, Wilder-Smith OHG. Echocardiographic assessment of the haemodynamic effects of propofol: a comparison with etomidate and thiopentone. Anaesthesia 1991; 46: 99–105.
Coetzee A, Fourie P, Coetzee J, et al. Effect of various propofol plasma concentrations on regional myocardial contractility and left ventricular afterload. Anesth Analg 1989; 69: 473–83.
Brüssel T, Theissen JL, Vigfusson G, Lunkenheimer PP, Van Aken H, Lawin P. Hemodynamic and cardiodynamic effects of propofol and etomidate: negative inotropic properties of propofol. Anesth Analg 1989; 69: 35–40.
De Hen SG, Vermeyen KM, Adriaensen HE Influence of thiopental, etomidate, and propofol on regional myocardial function in the normal and acute ischemic heart segment in dogs. Anesth Analg 1990; 70: 600–7.
Diedericks J, Foëx P, Sear JW, Ryder WA. Haemo-dynamic effects of propofol infusion: dose-response study in compromised canine hearts. Br J Anaesth 1989; 64: 393P
Diedericks J, Leone BJ, Sear JW, Foëx P, Ryder WA. Effect of nitrous oxide during basal propofol anaesthesia on myocardium with normal and critically restricted blood supply. Br J Anaesth 1989; 62: 224P
Puttick RM, Diedericks J, Sear JW, Glen JB, Foëx P, Ryder WA. Effect of graded infusion rates of propofol on regional and global left ventricular function in the dog. Br J Anaesth 1992; 69: 375–81.
Lepage JYM, Pinaud ML Helios JH, Cozian AY, Le Normand Y, Souron RJ. Left ventricular performance during propofol or methohexital anesthesia: isotopic and invasive cardiac monitoring. Anesth Analg 1991; 73: 3–9.
Pagel PS, Warltier DC. Negative inotropic effects of propofol as evaluated by the regional preload recruitable stroke work relationship in chronically instrumented dogs. Anesthesiology 1993; 78: 100–8.
Mayer N, Legat K, Weinstabl C, Zimpfer M. Effects of propofol on the function of normal, collateral-dependent, and ischemic myocardium. Anesth Analg 1993; 76 33–9.
Park WK, Lynch C 3rd. Propofol and thiopental depression of myocardial contractility. A comparative study of mechanical and electrophysiologic effects in isolated guinea pig ventricular muscle. Anesth Analg 1992; 74: 395–405.
Belo SE, Kolesar R, Mazer CD. Effect of intracoronary propofol on myocardial contractility in the dog. 14th Annual Meeting, Society of Cardiovascular Anesthesiologists 1992; 201.
Ismail EF, Kim SJ, Salem MR. Direct effects of propofol on myocardial contractility inin situ canine hearts. Anesthesiology 1992; 77: 964–72.
Khatib SY, Talafih KF, Takrouri MS. The hemodynamic effects of propofol on the isolated rabbit heart. Middle East Journal of Anaesthesia 1992; 11: 455–66.
Goodchild CS, Serrao JM. Cardiovascular effects of propofol in the anaesthetized dog. Br J Anaesth 1989; 63: 87–92.
Riou B, Besse S. Lecarpentier Y, Viars P.In vitro effects of propofol on rat myocardium. Anesthesiology 1992; 76: 609–16.
Pagel PS, Schmeling WT, Kampine JP, Warltier DC. Alteration of canine left ventricular diastolic function by intravenous anesthetics in vivo. Anesthesiolgy 1992; 76: 419–25.
Cullen PM, Turtle M, Prys-Roberts C, Way WL, Dye J. Effect of propofol anesthesia on baroreflex activity in humans. Anesth Analg 1987; 66: 1115–20.
Samain E, Marty J, Gauzit R et al. Effects of propofol on baroreflex control of heart rate and on plasma noradrenaline levels. Eur J Anaesthesiol 1989; 6: 321–6.
Blake DW, Jover B, McGrath BP. Haemodynamic and heart rate reflex responses to propofol in the rabbit. Br J Anaesth 1988; 61: 194–9.
Kamijo Y, Goto H, Nakazawa K, Benson KT, Arakawa K. Arterial baroreflex attenuation during and after continuous propofol infusion. Can J Anaesth 1992; 39: 987–91.
Sneyd JR, Berry A. Effect of preinduction glycopyrrolate on the hemodynamic response to anesthesia with propofol. Anesth Analg 1991; 72: 831–4.
Skues MA, Richards MJ, Jarvis AP, Prys-Roberts C. Preinduction atropine or glycopyrrolate and hemodynamic changes associated with induction and maintenance of anesthesia with propofol and alfentanil. Anesth Analg 1989; 69: 386–90.
Slogojf S, Keats AS. Does perioperative myocardial ischemia lead to postoperative myocardial infarction? Anesthesiology 1985; 62: 107–14.
Mangano DT. Perioperative cardiac morbidity. Anesthesiology 1990; 72: 153–84.
Stephan H, Sonntag H, Schenk HD, Kettler D, Khambatta HJ. Effects of propofol on cardiovascular dynamics, myocardial blood flow and myocardial metabolism in patients with coronary artery disease. Br J Anaesth 1986; 58: 969–75.
Vermeyen KM, De Hert SG, Erpels FA, Adriaensen HF. Myocardial metabolism during anaesthesia with propofollow dose fentanyl for coronary artery bypass surgery. Br J Anaesth 1991; 66: 504–8.
Hall RI, Murphy JT, Moffitt EA, Landymore R, Pollak PT, Poole L. A comparison of the myocardial metabolic and haemodynamic changes produced by propofol-sufentanil and enflurane-sufentanil anaesthesia for patients having coronary artery bypass graft surgery. Can J Anaesth 1991; 38: 996–1004.
Thomson SJ, Yate PM. Bradycardia after propofol infusion (Letter). Anaesthesia 1987; 42: 430.
Baraka A. Severe bradycardia following propofol-suxamethonium sequence. Br J Anaesth 1988; 61: 482–3.
Briggs I, Heapy CG, Pickering L. Electrophysiological effects of propofol on isolated sinoatrial node preparations and isolated atrial conductionin vitro. Br J Pharmacol 1989; 97: 504-P.
Puttick RM, Terror DA. Effects of propofol on membrane currents and contraction in single myocytes isolated from guinea-pig ventricle. Br J Pharmacol 1989; 98: 742P.
Saarnivaara L, Klemola UM, Lindgren L, Rautiainen P, Suvanto A. QT interval of the ECG, heart rate and arterial pressure using propofol, methohexital or midazolam for induction of anaesthesia. Acta Anaesthesiol Scand 1990; 34: 276–81.
Ori C, Dam M, Pizzolato G. Effetti del propofol (Diprivan) sull’attività funzionale cérébrale: correlazioni tra metabolismo, flusso ematico, attività elettrica e stato energetico tessutale. Acta Anesthesiologica Italica 1990; 41: 1–23.
Dam M, Ori C, Pizzolato G, et al. The effects of propofol anesthesia on local cerebral glucose utilization in the rat. Anesthesiology 1990; 73: 499–505.
Cavazzuti M, Porro CA, Barbieri A, Galetti A. Brain and spinal cord metabolic activity during propofol anaesthesia. Br J Anaesth 1991; 66: 490–5.
Stephan H, Sonntag H, Schenk HD, Kohlhausen S. Effects of disoprivan on cerebral blood flow, cerebral oxygen consumption, and cerebral vascular reactivity. Anaesthesist 1987; 36: 60–5.
Ravussin P, Guinard JP, Ralley F, Thorin D. Effect of propofol on cerbrospinal fluid pressure and cerebral perfusion pressure in patients undergoing craniotomy. Anaesthesia 1988; 43: 37–41.
Ravussin P, Thorin D, Guinard JP, Freeman J. Effect of propofol on cerebro-spinal fluid pressure in patients with and without intracranial hypertension. J Drug Dev 1989; 2 (Suppl 2): 105–6.
Moss E, Price DJ. Effect of propofol on brain retraction pressure and cerebral perfusion pressure. Br J Anaesth 1990; 65: 823–5.
Kalkman CJ, Traast H, Zuurmond WWA, Bovill JG. Differential effects of propofol and nitrous oxide on posterior tibial nerve somatosensory cortical evoked potentials during alfentanil anaesthesia. Br J Anaesth 1991; 66: 483–9.
Savoia G, Esposito C, Belfiore F, Amantea B, Cuocolo R. Propofol infusion and auditory evoked potentials. Anaes-thesia 1988; 43: 46–9.
Kochs E, Hoffman WE, Werner C, Thomas C, Albrecht RF, Schulte am Esch J. The effects of propofol on brain electrical activity, neurologic outcome, and neuronal damage following incomplete ischemia in rats. Anesthesiology 1992; 76: 245–52.
Weir DL, Goodchild CS, Graham DI. Propofol: effects on indices of cerebral ischemia. Journal of Neurosurgical Anesthesiology 1989; 1: 284–9.
Oei-Lim VLB, Kalkman CJ, Bouvy-Berends ECM, et al. A comparison of the effects of propofol and nitrous oxide on the electroencephalogram in epileptic patients during conscious sedation for dental procedures. Anesth Analg 1992; 75: 708–14.
Hufnagel A, Elger CE, Nadstawek J, Stoeckel H, Böker DK. Specific response of the epileptic focus to anesthesia with propofol. Journal of Epilepsy 1990; 3: 37–45.
Bone ME, Wilkins CJ, Lew JK. A comparison of propofol and methohexitone as anaesthetic agents for electrocon-vulsive therapy. Eur J Anaesthesiol 1988; 5: 279–86.
Rampton AJ, Griffin RM, Stuart CS, Durcan JJ, Huddy NC, Abbott MA. Comparison of methohexital and propofol for electroconvulsive therapy: effects on hemodynamic responses and seizure duration. Anesthesiology 1989; 70: 412–7.
Lowson S, Gent JP, Goodchild CS. Anticonvulsant properties of propofol and thiopentone: comparison using two tests in laboratory mice. Br J Anaesth 1990; 64: 59–63.
Hasan ZA, Hasan MM, Al-Hader AA, Takrouri MS. The effect of propofol and thiopentone on pentylenetetrazol seizure threshold in the rat. Middle East Journal of Anesthesia 1992; 11: 359–67.
Wood PR, Browne GPR, Pugh S. Propofol infusion for the treatments of status epilepticus (Letter). Lancet 1988; I: 480–1.
Mackenzie SJ, Kapadia F, Grant IS. Propofol infusion for control of status epilepticus. Anaesthesia 1990; 45: 1043–5.
Gold MI, Abraham EC, Herrington C. A controlled investigation of propofol, thiopentone and methohexitone. Can J Anaesth 1987; 34: 478–83.
Thomson KD, Payne JP. Effect of oxygen on arterial saturation during induction of anaesthesia with propofol. Br J Anaesth 1987; 59: 1318P.
Ponte J, Sadler CL. Effect of thiopentone, etomidate and propofol on carotid body chemoreceptor activity in the rabbit and the cat. Br J Anaesth 1989; 62: 41–5.
Goodman NW, Black AMS, Carter JA. Some ventilatory effects of propofol as sole anaesthetic agent. Br J Anaesth 1987; 59: 1497–503.
Grounds RM, Lalor JM, Lumley J, Royston D.Morgan M. Propofol infusion for sedation in the intensive care unit: preliminary report. BMJ 1987; 294: 397–400.
Allsop P, Taylor MB, Grounds RM, Morgan M. Ventilatory effects of a propofol infusion using a method to rapidly achieve steady-state equilibrium. Eur J Anaesthesiol 1988; 5: 293–303.
Conti G, Dell’Utri D, Vilardi V, et al. Propofol induces bronchodilation in mechanically ventilated chronic obstructive pulmonary disease (COPD) patients. Acta Anaesthesiol Scand 1993; 37: 105–9.
Rosa G, Conti G, Orsi P, et al. Effects of low-dose propofol administration on central respiratory drive, gas exchanges and respiratory pattern. Acta Anaesthesiol Scand 1992; 36: 128–31.
Ben-Shlomo I, Finger J, Bar-Av E, Perl AZ, Etchin A, Tverskoy M. Propofol and fentanyl act additively for induction of anaesthesia. Anaesthesia 1993; 48: 111–3.
McCollum JSC, Dundee JW. Comparison of induction characteristics of four intravenous anaesthetic agents. Anaesthesia 1986; 41: 995–1000.
Van Aken H, Meinshausen E, Prien T, Brüssel T, Heinecke A, Lawin P. The influence of fentanyl and tracheal intubation on the hemodynamic effects of anesthesia induction with propofol/N2O in humans. Anesthesiology 1988; 68: 157–63.
Roily G, Versichelen L, Huyghe L, Mungroop H. Effect of speed of injection on induction of anaesthesia using propofol. Br J Anaesth 1985; 57: 743–6.
Stokes DN, Hutton P. Rate-dependent induction phenomena with propofol: implications for the relative potency of intravenous anesthetics. Anesth Analg 1991; 72: 578–83.
Peacock JE, Lewis RP, Reilly CS, Nimmo WS. Effect of different rates of infusion of propofol for induction of anaesthesia in elderly patients. Br J Anaesth 1990; 65: 346–52.
Peacock JE, Spiers SPW, McLauchlan GA, Edmondson WC, Berthoud M, Reilly CS. Infusion of propofol to identify smallest effective doses for induction of anaesthesia in young and elderly patients. Br J Anaesth 1992; 69: 363–7.
Goldhaber JI, Weiss JN. Oxygen free radicals and cardiac reperfusion abnormalities. Hypertension 1992; 20: 118–27.
Murphy PG, Myers DS, Davies MJ, Webster NR, Jones JG. The antioxidant potential of propofol (2,6-diisopropylphenol). Br J Anaesth 1992; 68: 613–8.
Musacchio E, Rizzoli V, Bianchi M, Bindoli A, Galzigna L. Antioxidant action of propofol on liver microsomes, mitochondria and brain synaptosomes in the rat. Pharmacol Toxicol 1991; 69: 75–7.
Bianchi M, Battistin T, Galzigna L. 2, 6-diisopropyl-phenol, a general anesthetic, inhibits glutamate action on rat synaptosomes. Neurochem Res 1991; 16: 443–6.
Siesjö BK, Bengtsson F. Calcium fluxes, calcium antagonists, and calcium-related pathology in brain ischemia, hypoglycemia and spreading depression: a unifying hypothesis. J Cerebr Blood Flow Metab 1989; 9: 127–40.
O’Domell NG, McSharry CP, Wilkinson PC, Asbury AJ. Comparison of the inhibitory effect of propofol, thiopentone and midazolam on neutrophil polarizationin vitro in the presence or absence of human serum albumin. Br J Anaesth 1992; 69: 70–4.
Jensen AG, Dahlgren C, Eintrei C. Propofol decreases random and chemotactic stimulated locomotion of human neutrophilsin vitro. Br J Anaesth 1993; 70: 99–100.
Burnham WR, Heptinstall S, Cockbill SR Harrison S. Blood platelet behavior during infusion of an Intralipid-based intravenous feeding mixture. Postgrad Med J 1982; 58: 152–5.
Reid DI, Ingram GIL. Changes in blood coagulation during infusion of intralipid. Clin Sci 1967; 33: 339–42.
Sear JW, Uppington J, Kay NH. Haematological and biochemical changes during anaesthesia with propofol (Diprivan). Postgrad Med J 1985; 61 (Suppl 3): 165–8.
Newman LH, McDonald JC, Wallace PGM, Ledingham IMcA. Propofol infusion for sedation in intensive care. Anaesthesia 1987; 42: 929–37.
Beller JP, Pottecher T, Lugnier A, Mangin P, Otteni JC. Prolonged sedation with propofol in ICU patients: recovery and blood concentration changes during periodic interruptions in infusion. Br J Anaesth 1988; 61: 583–8.
Doenicke A, Lorenz W, Stanworth D, Duka T, Glen JB. Effects of propofol (Diprivan) on histamine release, immunoglobulin levels and activation of complement in healthy volunteers. Postgrad Med J 1985; 61: 15–20.
Stellato C, Casolaro V, Ciccarelli A, Mastronardi P, Mazzarella B, Marone G. General anaesthetics induce only histamine release selectively from human mast cells. Br J Anaesth 1991; 67: 751–8.
Laxenaire MC, Mata E, Guéant JL, Moneret- Vautrin DA, Haberer JP. Basophil histamine release in atopic patients afterin vitro provocation with thiopental, Diprivan® and chlormethiazole. Acta Anaesthesiol Scand 1991; 35: 706–10.
Laxenaire MC, Guéant JL, Bermejo E, Mouton C, Navez MX Anaphylactic shock due to propofol (Letter). Lancet 1988; II: 739–40.
Laxenaire MC, Guéant JL, Moneret- Vautrin DA et al. Chocs anaphylactiques au propofol lors de la première utilisation. Ann Fr Anesth Réanim 1990; 9: R125.
de Leon-Casasola OA, Weiss A, Lema MJ. Anaphylaxis due to propofol. Anesthesiology 1992; 77: 384–6.
Laxenaire MC, Mata-Bermejo E, Moneret-Vautrin DA, Guéant JL. Life-threatening anaphylactoid reactions to propofol (Diprivan®). Anesthesiology 1992; 77: 275–80.
Patrick MR, Blair IJ, Feneck RO, Sebel PS. A comparison of the haemodynamic effects of propofol (Diprivan) and thiopentone in patients with coronary artery disease. Postgrad Med J 1985; 61: 23–7.
Vermeyen KM, Erpels FA, Janssen LA, Beeckman CP, Hanegreefs GH. Propofol-fentanyl anaesthesia for coronary bypass surgery in patients with good left ventricular function. Br J Anaesth 1987; 59: 1115–20.
Roberts FL Dixon J, Lewis GTR, Thckley RM, Prys-Roberts C. Induction and maintenance of propofol anaesthesia. Anaesthesia 1988; 43: 14–7.
Manara AR, Monk CR, Bolsin SN, Prys-Roberts C. Total i.V. anaesthesia with propofol and alfentanil for coronary artery bypass grafting. Br J Anaesth 1991; 66: 716–8.
Griffiths D, Jones JG. Awareness and memory in anaesthetized patients (Editorial). Br J Anaesth 1990; 65: 603–6.
Bethune DW, Ghosh S, Gray B, et al. Learning during general anaesthesia: implicit recall after methohexitone or propofol infusion. Br J Anaesth 1992; 69: 197–9.
Chong JL, Pillai R, Fisher A, Grebenik C, Sinclair M, Westaby S. Cardiac surgery: moving away from intensive care. Br Heart J 1992; 68: 430–3.
Zacny JP, Lichtor JL Coalson DW et al. Subjective and psychomotor effects of subanesthetic doses of propofol in healthy volunteers. Anesthesiology 1992; 76: 696–702.
Bodenham A, Culank LS, Park GR. Propofol infusion and green urine (Letter). Lancet 1987; 2: 740.
Follette JW, Farley WJ. Anesthesiologist addicted to propofol. Anesthesiology 1992; 77: 817–8.
Valtonen M, Kanto J, Klossner J. Anaesthesia for cardioversion: a comparison of propofol and thiopentone. Can J Anaesth 1988; 35: 479–83.
Mitterschijfthaler G, Lechleitner P, Hauptlorenz S, Wencker M, Dienstl F. Anesthésie pour cardioversion. Comparaison du propofol et de l’étomidate. Cahiers d’Anesthésiologie 1990; 38: 159–63.
Canessa R, Lema G, Urzúa J, Dagnino J, Concha M. Anesthesia for elective cardioversion: a comparison of four anesthetic agents. J Cardiothorac Vase Anesth 1991; 5: 566–8.
Sternlo JE, Hägerdal M. Anaesthesia for cardioversion - clinical experiences with propofol and thiopentone. Acta Anaesthesiol Scand 1991; 35: 606–8.
Snellen F, Lauwers P, Demeyere R, Byttebier G, Van Aken H. The use of midazolam versus propofol for shortterm sedation following coronary artery bypass grafting. Intensive Care Med 1990; 16: 312–6.
McMurray TJ, Collier PS, Carson IW, Lyons Sm, Elliot P. Propofol sedation after open heart surgery. A clinical and pharmacokinetic study. Anaesthesia 1990; 45: 322–6.
Aitkenhead AR, Pepperman ML, Willats SM, et al. Comparison of propofol and midazolam for sedation in critically ill patients. Lancet 1989; II: 704–9.
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Searle, N.R., Sahab, P. Propofol in patients with cardiac disease. Can J Anaesth 40, 730–747 (1993). https://doi.org/10.1007/BF03009770
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DOI: https://doi.org/10.1007/BF03009770