Propofol clearance and distribution volume increase in patients with hyperthyroidism

Anesthesia and Analgesia
T TsubokawaT Kobayashi

Abstract

We investigated propofol pharmacokinetics in seven hyperthyroid (Group H) and eight euthyroid (Group E) patients undergoing elective subtotal thyroidectomy. Anesthesia was induced with an i.v. injection of 2 mg/kg propofol and maintained with a continuous propofol infusion while ventilation was controlled with 60% nitrous oxide in oxygen. The propofol infusion rate was adjusted in the range of 4-10 mg.kg-1.h-1 based on physiological signs such as heart rate and blood pressure. Arterial blood was sampled to measure the propofol concentration. The mean propofol infusion rates were higher in hyperthyroid than in patients with euthyroidism (median values Group H 10.0 mg.kg-1.h-1, Group E 6.5 mg.kg-1.h-1; P < 0.05), although the reverse was true for average propofol concentrations (Group H 1.8 micrograms/mL, Group E 3.3 micrograms/mL; P < 0.05). Group H also had higher values for propofol clearance (5.1 L/min versus 2.5 L/min; P < 0.05) and distribution volume at steady state (10.0 L/kg versus 2.8 L/kg; P < 0.05). Because distribution volume and clearance in patients with hyperthyroidism were increased, propofol concentrations could not reach anesthetic levels. Propofol decreases heart rate and blood pressure, which are desirable pr...Continue Reading

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Citations

Dec 2, 2015·Experimental and Therapeutic Medicine·Yang WangY U Wan
Oct 8, 2009·Journal of Clinical Pharmacology·Norio TakahashiHirotoshi Nakamura
May 26, 2004·Annales Françaises D'anesthèsie Et De Rèanimation·S MératB Pats
Jan 29, 2005·Acta Anaesthesiologica Scandinavica·A VarelaE López

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