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http://dx.doi.org/10.3340/jkns.2014.56.2.135

Propofol Infusion Associated Metabolic Acidosis in Patients Undergoing Neurosurgical Anesthesia : A Retrospective Study  

Choi, Yoon Ji (Department of Dental Anesthesiology, Seoul National University Dental Hospital)
Kim, Min Chul (Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul National University)
Lim, Young Jin (Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University)
Yoon, Seung Zhoo (Department of Anesthesiology and Pain Medicine, College of Medicine, Korea University)
Yoon, Suk Min (Department of Anesthesiology and Pain Medicine, College of Medicine, Korea University)
Yoon, Hei Ryeo (Department of Nutrition, Food Service Management, College of Industrial Science, Kongju National University)
Publication Information
Journal of Korean Neurosurgical Society / v.56, no.2, 2014 , pp. 135-140 More about this Journal
Abstract
Objective : Propofol and volatile anesthesia have been associated with metabolic acidosis induced by increased lactate. This study was designed to evaluate changes in pH, base excess (BE), and lactate in response to different anesthetic agents and to characterize propofol infusion-associated lactic acidosis. Methods : The medical records of patients undergoing neurosurgical anesthesia between January 2005 and September 2012 were examined. Patients were divided into 2 groups : those who received propofol (total intravenous anesthesia, TIVA) and those who received sevoflurane (balanced inhalation anesthesia, BIA) anesthesia. Propensity analysis was performed (1 : 1 match, n=47), and the characteristics of the patients who developed severe acidosis were recorded. Results : In the matched TIVA and BIA groups, the incidence of metabolic acidosis (11% vs. 13%, p=1) and base excess (p>0.05) were similar. All patients in the TIVA group who developed severe acidosis did so within 4 hours of the initiation of propofol infusion, and these patients improved when propofol was discontinued. Conclusions : The incidence of metabolic acidosis was similar during neurosurgical anesthesia with propofol or sevoflurane. In addition, severe acidosis associated with propofol infusion appears to be reversible when propofol is discontinued.
Keywords
Acidosis; Neurosurgery; Propofol;
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