Abstract
Objective: To investigate the effect of low-dose propofol infusion on total-body oxygen consumption (V0 2) after coronary artery bypass grafting (CABG) surgery. Design: A prospective, randomized, placebo-controlled, double-blind study. Setting: Cardiovascular intensive care unit in a university hospital. Participants: Thirty patients after elective, uncomplicated CABG surgery. Intervention: Patients were administered a continuous infusion of propofol with a fixed rate of 1 mg/kg/h (n = 15) or placebo (n = 15) during the spontaneous rewarming period of approximately 5 hours after surgery. A light level of sedation (Ramsay sedation score ≥2) was maintained by administering small doses of diazepam, 0.1 mg/kg, as required. Morphine, 0.05 mg/kg, was administered for analgesia as required. Measurements and Main Results: Total-body V0 2 was measured by indirect calorimetry. In addition, shivering (on a five-grade scale), hemodynamics, and plasma catecholamine and serum cortisol concentrations were measured. Diazepam, 5.6 ± 7.4 mg (mean ± standard deviation), was administered to the patients receiving propofol, and 16.1 ± 12.2 mg was administered to the patients receiving placebo ( p < 0.05). There was no difference in the dose of morphine between the groups (3.2 ± 3.9 v 4.2 ± 5.5 mg in the propofol and placebo groups, respectively). At any time during the study, V0 2 was not different between the groups. VO 2 increased from 130 ± 29 to 172 ± 29 mL/min/m 2 in the propofol group and from 118 ± 24 to 167 ± 27 mL/min/m 2 in the placebo group. Mean arterial pressure and heart rate were lower in the propofol group ( p < 0.05). Stress hormone levels did not differ between the groups. Conclusion: Low-dose propofol infusion and additional diazepam as required does not decrease total-body V02 compared with a pure diazepam bolus-dose technique when administered for light sedation during the immediate recovery period after CABG surgery.
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