Related Experiment Videos
Acute tachyphylaxis to propofol sedation during ethanol withdrawal
1Department of Anesthesiology, Case Western Reserve University, Cleveland, OH, USA.
Journal of Clinical Anesthesia
|August 1, 1997
Summary
This case study describes a patient who developed acute tachyphylaxis to propofol during anesthesia emergence. Despite increasing doses, propofol lost effectiveness, necessitating a switch to thiopental for sedation.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Patient history includes 30 years of ethanol and benzodiazepine abuse.
- Emergence from general anesthesia presented with combativeness and confusion.
Observation:
- Initial sedation achieved with low-dose propofol (10-20 mg) and midazolam infusion (50 mg/hr).
- Patient became increasingly agitated, hypertensive, and tachycardic despite high-dose propofol infusion (up to 1,000 µg/kg/min).
Findings:
- Propofol infusion up to 1,755 mg total dose failed to sedate the patient.
- Thiopental bolus (500 mg) and infusion (200 mg/hr) rapidly achieved sedation.
Implications:
- This case may represent the first documented instance of acute tachyphylaxis to propofol.
- Highlights the potential for rapid tolerance development to propofol, impacting anesthetic management.