Family Medicine, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
Pediatric Anesthesia, Institute of Pediatrics of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
Pharmacology. 2023;108(5):415-422. doi: 10.1159/000533327. Epub 2023 Aug 25.
Propofol occasionally induces a green or pink-cloudy urine discoloration. A lesser-known effect is green discoloration of hair, milk, liver, or stool. We aimed to gain insight into the features of these disturbances.
The terms ("propofol" OR "fospropofol") AND ("green" OR "pink" OR "cloudy" OR "pink-cloudy") were searched in Excerpta Medica, MEDLINE/PubMed®, and Web of Sciences databases, with no language limit, from inception up to February 2023 (CRD4202236804). Articles reporting individually documented cases were retained, and data were extracted using a checklist.
Seventy-seven original reports documented 95 cases (including 13 subjects ≤18 years of age). Completeness of reporting was satisfactory in 33, good in 35, and excellent in 27 cases. Propofol-associated green urine discoloration was observed in 54 patients. In most instances (n = 21, 39%), propofol was given for ≥24 h. Sometimes, however, the urine discoloration developed after propofol for ≤3 h (n = 12, 22%). Propofol-associated urine discoloration was usually observed during the administration of this agent, but it was at times (n = 11) first recognized ≥3 h after propofol discontinuation. The duration of green urine discoloration was usually ≤24 h after stopping propofol. Propofol-associated green urine discoloration was never associated with worsening kidney function. A pink-cloudy urine discoloration was observed in 32 subjects with an acidic urine pH and increased uric acid excretion given propofol for ≤24 h. A stage I acute kidney injury was observed in 2 cases (6.3%) of propofol-associated pink-cloudy urine discoloration. Nine cases of non-urinary green discoloration were observed: hair (n = 4), breast milk (n = 1), liver (n = 1), stool (n = 1).
Propofol is sometimes associated with a green (benign) or pink-cloudy (occasionally associated with mild acute kidney injury) urine discoloration. Rarely, non-urinary green discoloration has been reported.
异丙酚偶尔会引起尿液呈绿色或粉红色云雾状变色。不太为人知的是，头发、牛奶、肝脏或粪便也会变成绿色。我们旨在深入了解这些异常的特征。
在 Excerpta Medica、MEDLINE/PubMed®和 Web of Sciences 数据库中，使用“propofol”或“fospropofol”和“green”或“pink”或“cloudy”或“pink-cloudy”作为检索词，不限制语言，从建库到 2023 年 2 月进行检索（CRD4202236804）。保留单独记录病例的文章，并使用检查表提取数据。
77 篇原始报告记录了 95 例（包括 13 例年龄≤18 岁的患者）。其中 33 例报告完整性满意，35 例报告良好，27 例报告优秀。54 例患者出现与异丙酚相关的绿色尿液变色。在大多数情况下（n=21，39%），患者使用异丙酚的时间≥24 h。然而，有时在使用异丙酚≤3 h 后也会出现尿液变色（n=12，22%）。异丙酚相关的尿液变色通常在使用该药物期间观察到，但有时（n=11）在停止使用异丙酚≥3 h 后首次发现。停止使用异丙酚后，绿色尿液变色通常持续≤24 h。与异丙酚相关的绿色尿液变色从未与肾功能恶化相关。32 例患者使用酸性尿液 pH 值和增加尿酸排泄的异丙酚后出现粉红色云雾状尿液变色。2 例（6.3%）异丙酚相关粉红色云雾状尿液变色患者出现 1 期急性肾损伤。观察到 9 例非尿液绿色变色：头发（n=4）、母乳（n=1）、肝脏（n=1）、粪便（n=1）。
异丙酚有时会导致尿液呈绿色（良性）或粉红色云雾状（偶尔与轻度急性肾损伤相关）变色。罕见情况下，报告了非尿液绿色变色。
