Short Term Propofol Anaesthesia Is Not Associated with an Increase in Blood Lactate: A Comparative Study with Sevoflurane

Constance Sat Lin Liew

doi:10.11648/j.ja.20160402.11

Abstract

This research was conducted considering the fact that today, there are still very few studies comparing Sevoflurane or Target Controlled Infusion using Propofol in term of serum lactate accumulation during general anaesthesia. There were 92 patients aged 18-65 years old, classified under ASA I, were involved in this prospective study. They were divided into 2 groups and this study was done in a double-blind manner. Patients received either Sevoflurane inhalational or Propofol infusion using Marsh model (target plasma concentration of 5 mcg/ml) during operation. All the patients received anaesthesia in a standard practice and blood samples were taken at every hour until completion of operation. The blood samples were tested for acid-base values and lactate level. There are significant differences in the mean values of serum lactate levels at 1st, 2nd, 3rd and 4th hour of surgery within propofol and sevoflurane group with p value of < 0.05. Nevertheless, when comparing differences in the mean values of serum lactate levels between propofol and sevoflurane group showed no significant difference of serum lactate change with p=0.186. In conclusion, our study shows that short term anaesthesia with sevoflurane is associated with an increase blood lactate levels more than lactate levels observed during high dose propofol anaesthesia.

Highlights

Propofol is an intravenous short-acting sedative hypnotic agent that has been in use for over three decades
We observed a statistically significant increase in serum lactate levels in sevoflurane group, compared with propofol group, an alternative explanation for the difference in blood lactate levels between sevoflurane and propofol groups may be a different effect of these anaesthetics on lactate metabolism, on lactate production, lactate clearance via the liver or kidneys, or the imbalance between both
The results of our study show that short term anaesthesia with sevoflurane is associated with an increase in blood lactate levels that are more than lactate levels observed during high-dose propofol anaesthesia

Summary

Introduction

Propofol is an intravenous short-acting sedative hypnotic agent that has been in use for over three decades. It has a rapid onset of action within seconds and a very short half-life about 3 to 10 minutes. It was initially used as an inducing agent for general anaesthesia. The short context-sensitive half-time of propofol, even with prolonged periods of infusion, combined with the short effect-site equilibration time, make this an titratable drug for production of intravenous sedation [1]. The prompt recovery without residual sedation, vomiting and nausea make this drug well suited for short duration surgical procedures. The typical conscious sedation dose for propofol is 25 to

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