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Online ISSN 1827-1596
Zattoni J. 1, Rossi A. 1, Cella F. 1, Ori C. 2, Facco E. 2, Giron G. P. 2, Stocchetti N. 3, Chieregato A. 4, Serioli T. 3, Zuccoli P. 3, Parma A. 5, Trazzi R. 5
From the Department of Anaesthesia and Intensive Care
1 University of Genova
2 University of Padova
3 Ospedali Riuniti, Parma
4 Ospedale Bufalini, Cesena
5 University of Milan
Background. The 2% formulation of the intravenous anaesthetic agent, propofol (Dipri-van™), delivers half the amount of lipid compared with the original 1% formulation. This may provide an acceptable alternative for patients who have an impaired ability to metabolise lipids.
Methods. This study was a multicentre, randomised, open comparison of parallel groups. Seventy-three adult patients undergoing elective craniotomy in neurosurgery were randomised to receive either propofol 1% (10 mg/ml) or propofol 2% (20 mg/ml) for induction and maintenance of anaesthesia.
Results. Analysis of induction time (199 s, 1%; 202 s, 2%; p>0.05) and induction dose (1.13 mg/kg, 1.12 mg/kg; p>0.05) shows that propofol 1% and propofol 2% are pharmacodynamically equivalent. Both formulations were similar regarding overall administration rates, recovery times, haemodynamic variables and tolerability. Plasma triglyceride levels, were lower in the propofol 2% group compared with the propofol 1% group, and significantly lower (p<0.05) from 1 to 4 hours after induction.
Conclusions. We conclude that propofol 2% is as effective and as well-tolerated as propofol 1% for anaesthesia and is an acceptable alternative to propofol 1% in patients undergoing elective craniotomy in neurosurgery. The lower lipid load suggests it may be of particular benefit to patients with disorders of lipid metabolism.