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Does propofol anesthesia affect intraoperative parathyroid hormone levels? A randomized, prospective trial
Rebecca S Sippel1, Yolanda T Becker, Jon S Odorico
1Department of Surgery, University of Wisconsin Medical School, 600 Highland Avenue, Madison, WI 53792, USA.
Surgery
|January 20, 2005
Summary
Propofol (2,6-diisopropylphenol) sedation does not significantly affect intraoperative parathyroid hormone (PTH) levels in vivo. Surgeons can safely use propofol during parathyroid surgery with intraoperative PTH monitoring.
Area of Science:
- Anesthesiology
- Endocrinology
- Surgical Monitoring
Background:
- Propofol is a common anesthetic agent.
- In vitro studies suggest propofol may interfere with parathyroid hormone (PTH) testing.
- This concern leads some surgeons to avoid propofol during parathyroidectomy.
Purpose of the Study:
- To investigate the in vivo effect of propofol on intraoperative PTH levels.
- To determine if propofol impacts the reliability of PTH assays during surgery.
Main Methods:
- 34 patients with secondary hyperparathyroidism undergoing dialysis access surgery were randomized.
- Patients received either propofol or midazolam sedation.
- PTH levels were measured pre-procedure, and at 10 and 30 minutes post-sedation.
Main Results:
- No statistically significant difference in PTH levels was observed between propofol and midazolam groups at any time point.
- The percentage change in PTH from baseline was similar between the two sedation groups.
- No patient experienced a sustained PTH drop greater than 50%.
Conclusions:
- Intravenous propofol infusion does not significantly alter intraoperative PTH levels.
- Intraoperative PTH assays can be safely utilized with propofol sedation during parathyroid surgical procedures.