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Haemodynamic changes during anaesthesia induced and maintained with propofol.

M A Claeys1, E Gepts, F Camu

  • 1Department of Anaesthesiology, Academisch Ziekenhuis, Flemish Free University, Brussels, Belgium.

British Journal of Anaesthesia
|January 1, 1988
PubMed
Summary

Propofol anesthesia in elderly patients caused significant drops in blood pressure due to decreased systemic vascular resistance. Heart rate and cardiac output remained stable, indicating hypotension is primarily a reduction in afterload.

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Area of Science:

  • Anesthesiology
  • Cardiovascular Physiology

Background:

  • Propofol is a widely used anesthetic agent.
  • Understanding its hemodynamic effects, especially in elderly populations, is crucial for safe clinical practice.

Purpose of the Study:

  • To investigate the hemodynamic effects of propofol induction and infusion in elderly patients.
  • To determine the impact of propofol on arterial pressure, systemic vascular resistance, cardiac output, stroke volume, and heart rate.

Main Methods:

  • A single dose of propofol (2 mg/kg) followed by a continuous infusion (6 mg/kg/h) was administered to 10 elderly patients.
  • Patients received premedication with lorazepam (1 mg IV) and breathed room air spontaneously.
  • Hemodynamic parameters were monitored throughout the 60-minute infusion period.

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Main Results:

  • Propofol induction and infusion led to statistically significant decreases in systolic (28% and 30%) and diastolic (19% and 25%) arterial pressures.
  • These reductions in blood pressure correlated with decreased systemic vascular resistance (21% post-induction, 30% during infusion).
  • Cardiac output, stroke volume, and heart rate were not significantly affected.

Conclusions:

  • The arterial hypotension observed with propofol is primarily attributed to a decrease in systemic vascular resistance (afterload).
  • The cardiovascular system in elderly patients did not exhibit compensatory increases in heart rate or cardiac output to counteract the reduced afterload.
  • These findings highlight the importance of monitoring blood pressure in elderly patients receiving propofol anesthesia.