Propofol Infusion Associated Metabolic Acidosis in Patients Undergoing Neurosurgical Anesthesia: A Retrospective Study.
10.3340/jkns.2014.56.2.135
- Author:
Yoon Ji CHOI
1
;
Min Chul KIM
;
Young Jin LIM
;
Seung Zhoo YOON
;
Suk Min YOON
;
Hei Ryeo YOON
Author Information
1. Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Acidosis;
Neurosurgery;
Propofol
- MeSH:
Acidosis*;
Acidosis, Lactic;
Anesthesia*;
Anesthesia, Inhalation;
Anesthesia, Intravenous;
Anesthetics;
Humans;
Hydrogen-Ion Concentration;
Incidence;
Lactic Acid;
Medical Records;
Neurosurgery;
Propofol*;
Retrospective Studies*
- From:Journal of Korean Neurosurgical Society
2014;56(2):135-140
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Propofol and volatile anesthesia have been associated with metabolic acidosis induced by increased lactate. This study was designed to evaluate changes in pH, base excess (BE), and lactate in response to different anesthetic agents and to characterize propofol infusion-associated lactic acidosis. METHODS: The medical records of patients undergoing neurosurgical anesthesia between January 2005 and September 2012 were examined. Patients were divided into 2 groups : those who received propofol (total intravenous anesthesia, TIVA) and those who received sevoflurane (balanced inhalation anesthesia, BIA) anesthesia. Propensity analysis was performed (1 : 1 match, n=47), and the characteristics of the patients who developed severe acidosis were recorded. RESULTS: In the matched TIVA and BIA groups, the incidence of metabolic acidosis (11% vs. 13%, p=1) and base excess (p>0.05) were similar. All patients in the TIVA group who developed severe acidosis did so within 4 hours of the initiation of propofol infusion, and these patients improved when propofol was discontinued. CONCLUSIONS: The incidence of metabolic acidosis was similar during neurosurgical anesthesia with propofol or sevoflurane. In addition, severe acidosis associated with propofol infusion appears to be reversible when propofol is discontinued.
