Document Detail


Incidence of propofol infusion syndrome during noninvasive radiofrequency ablation for atrial flutter or fibrillation.
MedLine Citation:
PMID:  17525588     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Propofol infusion syndrome is first manifest by unexplained metabolic acidosis. Its incidence is unknown. METHODS: Charts of all patients undergoing nonsurgical, catheter radiofrequency ablation for atrial flutter or fibrillation from 1999 through 2001 at Mayo Clinic Rochester, who received propofol and had an arterial blood gas drawn during the procedure, were reviewed retrospectively for metabolic acidosis, prospectively defined as base excess -2 or less. Of 301 radiofrequency ablation cases, 55 had an arterial blood gas. Virtually all radiofrequency ablation patients received propofol, so they could not be used as nonpropofol controls. Instead, all carotid endarterectomy patients in 2000 who did not receive propofol and had an arterial blood gas drawn after anesthetic induction and before surgical incision were used as a comparator group. RESULTS: In propofol radiofrequency ablation patients with no apparent cause of metabolic acidosis besides propofol, 13 of 55 (24%) had base excess of -2 or less, versus 22 of 267 carotid patients (8.2%) (P<0.01). Maximal negative base excess was -4.2+/-1.7 in these propofol patients and was not correlated with propofol dose, age, or fluid dose, versus base excess of -3.2+/-1.5 in carotid patients (P>0.05). Propofol patients received prolonged anesthetics (7 h) and high-dose propofol (20 mg/kg). CONCLUSIONS: This is the first incidence estimate of metabolic acidosis during prolonged propofol infusion and suggests that it is not rare. The study is limited by its retrospective nature and by the lack of baseline arterial blood gas data and will require confirmation by prospective study.
Authors:
Grant T Cravens; Douglas L Packer; Michael E Johnson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesiology     Volume:  106     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-25     Completed Date:  2007-06-28     Revised Date:  2008-03-05    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1134-8     Citation Subset:  AIM; IM    
Affiliation:
Anesthesiology Department, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Acidosis / chemically induced*
Anesthetics, Intravenous / adverse effects*
Atrial Fibrillation / surgery*
Atrial Flutter / surgery*
Catheter Ablation / methods*
Dose-Response Relationship, Drug
Endarterectomy, Carotid
Humans
Incidence
Infusions, Intravenous
Medical Records
Middle Aged
Propofol / adverse effects*
Retrospective Studies
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 2078-54-8/Propofol
Comments/Corrections
Comment In:
Anesthesiology. 2008 Feb;108(2):331; author reply 331-2   [PMID:  18212581 ]
Anesthesiology. 2008 Feb;108(2):330; author reply 331-2   [PMID:  18212580 ]

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