J Korean Neurosurg Soc.  2014 Aug;56(2):135-140. 10.3340/jkns.2014.56.2.135.

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

• Choi YJ
• Kim MC
• Lim YJ
• Yoon SZ
• Yoon SM
• Yoon HR

• KMID: 1956516
• DOI: http://doi.org/10.3340/jkns.2014.56.2.135

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.

Keyword

Acidosis; Neurosurgery; Propofol

MeSH Terms

Acidosis*
Acidosis, Lactic
Anesthesia*
Anesthesia, Inhalation
Anesthesia, Intravenous
Anesthetics
Humans
Hydrogen-Ion Concentration
Incidence
Lactic Acid
Medical Records
Neurosurgery
Propofol*
Retrospective Studies*
Anesthetics
Lactic Acid
Propofol

Figure

• 

  Fig. 1 Flow diagram of the progression through the study. TIVA : total intravenous anesthesia, BIA : balanced inhalation anesthesia.

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