Bhukal Ishwar, Thimmarayan Gokul, Bala Indu, Solanki Sohan Lal, Samra Tanvir
Department of Anesthesia and Intensive Care, Post graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Mumbai, India.
Saudi J Anaesth. 2014 Nov;8(Suppl 1):S53-6. doi: 10.4103/1658-354X.144076.
Significant increase in serum triglyceride (ST) concentration have been described in adult population after prolonged administration of propofol formulation containing long chain triglyceride (LCT). Though, medium chain triglyceride-LCT (MCT-LCT) propofol when compared with LCT propofol for long-term sedation in adults resulted in identical triglyceride levels, the elimination of triglyceride was faster in patients administered MCT-LCT propofol.
A total of 40 children were randomized into two groups of 20 each; Group I were induced with 1% LCT propofol (3 mg/kg) and Group II with 1% medium and LCT propofol and maintained with descalating dose of 20.15 and 10 mg/kg/h at 10 min intervals. Blood samples for ST concentration were obtained before induction of anesthesia, at the end of propofol infusion and 4 h after terminating propofol infusion.
ST levels were raised significantly above the basal values in both the groups but the rise was significantly higher in Group I (P < 0.05). Four hours after stopping propofol infusion the triglyceride levels were similar to the basal values in Group II, whereas in Group I the values were significantly greater than the baseline (P < 0.05) as well as those of Group II (P < 0.05). No clinically significant adverse effect of hypertriglyceridemia was observed.
Even short term anesthesia with LCT and MCT-LCT propofol (1%) leads to elevated ST levels. The increase in ST levels is less with MCT-LCT propofol and elimination of triglyceride is also rapid after terminating MCT-LCT propofol infusion.
长期使用含长链甘油三酯(LCT)的丙泊酚制剂后,成人血清甘油三酯(ST)浓度显著升高。虽然,与LCT丙泊酚相比,中链甘油三酯-长链甘油三酯(MCT-LCT)丙泊酚用于成人长期镇静时甘油三酯水平相同,但使用MCT-LCT丙泊酚的患者甘油三酯消除更快。
40名儿童被随机分为两组,每组20名;第一组用1%LCT丙泊酚(3mg/kg)诱导,第二组用1%中链和LCT丙泊酚诱导,并以20、15和10mg/kg/h的递减剂量维持,间隔10分钟。在麻醉诱导前、丙泊酚输注结束时和丙泊酚输注终止后4小时采集ST浓度的血样。
两组ST水平均显著高于基础值,但第一组升高更显著(P<0.05)。停止丙泊酚输注4小时后,第二组甘油三酯水平与基础值相似,而第一组的值显著高于基线(P<0.05)以及第二组(P<0.05)。未观察到高甘油三酯血症的临床显著不良反应。
即使使用LCT和MCT-LCT丙泊酚(1%)进行短期麻醉也会导致ST水平升高。MCT-LCT丙泊酚导致的ST水平升高较少,且在终止MCT-LCT丙泊酚输注后甘油三酯消除也很快。