Karan Abhinav, Maaliki Naji, Kogler William M, Esmail Khadeeja
Internal Medicine, University of Florida College of Medicine, Jacksonville, USA.
Cardiology, University of Florida College of Medicine, Jacksonville, USA.
Cureus. 2023 Jul 13;15(7):e41815. doi: 10.7759/cureus.41815. eCollection 2023 Jul.
Propofol is a widely used general anesthetic agent with a generally familiar and predictable adverse effect profile. Severe left ventricular dysfunction to an ejection fraction of < 35% is a rare adverse effect of propofol, with a scarcity of data in the literature. In this case, we report a 36-year-old female at 36 weeks gestation with a prior remote history of peripartum cardiomyopathy, who, while receiving propofol for general anesthesia during a C-section, developed severe left ventricular dysfunction with an ejection fraction of 20-25%, flash pulmonary edema, and cardiogenic shock. She required initiation of inotropic support and, following weaning of propofol, gradually recovered her ejection fraction over the next 24 hours to 40-45% and to 50-55% at follow-up two weeks after discharge. This case highlights a unique adverse effect of propofol with scarce pre-existing literature and no guidelines on appropriate management. It is essential for clinicians to be familiar with this uncommon complication, particularly as propofol use continues to rise worldwide.
丙泊酚是一种广泛使用的全身麻醉剂，其不良反应通常为人熟知且具有可预测性。射血分数<35%的严重左心室功能障碍是丙泊酚罕见的不良反应，文献中相关数据较少。在此病例中，我们报告一名36岁孕36周的女性，既往有围产期心肌病病史，在剖宫产全身麻醉期间接受丙泊酚时，出现严重左心室功能障碍，射血分数为20% - 25%，伴有急性肺水肿和心源性休克。她需要开始使用正性肌力药物支持，在停用丙泊酚后，在接下来的24小时内射血分数逐渐恢复至40% - 45%，出院两周后的随访中恢复至50% - 55%。该病例突出了丙泊酚一种独特的不良反应，此前相关文献稀少且无适当管理的指南。临床医生熟悉这种罕见并发症至关重要，尤其是在全球丙泊酚使用持续增加的情况下。
