Effets hémodynamiques du propofol utilisé comme agent unique pour l'induction de l'anesthésie

Abstract

Haemodynamic effects of propofol were studied during induction of anaesthesia, in 20 patients undergoing abdominal aortic replacement. Eight of them suffered from coronary arterial disease. Propofol was used at a dose of 2 mg · kg −1. During 5 min after propofol administration, no drug was administered. Neither plasma expansion nor tracheal intubation were carried out. Haemodynamic changes were : 17% decrease in systolic arterial pressure, and 13% decrease in diastolic arterial pressure, associated with a 12% decrease in cardiac output and 7% decrease in systemic vascular resistances; no change in heart rate in spite of the decrease in arterial pressure; and a mild increase in diastolic pulmonary arterial pressure. Left ventricular systolic work and rate pressure product decreased, suggesting a favourable incidence in coronary disease by lowering myocardial oxygen consumption. Nevertheless, it must be considered that, in the group studied, patients with coronary disease receiving beta-blocking drugs were excluded. So, mild haemodynamic changes observed here have to be confirmed in patients suffering from more severe coronary arterial disease.