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British Journal of Anaesthesia, Vol 81, Issue 6 957-959, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia

SHORT COMMUNICATIONS

Cerebrospinal fluid concentrations of propofol during anaesthesia in humans

O. Engdahl, M. Abrahams, A. Bjornsson, M. Vegfors, B. Norlander, J. Ahlner and C. Eintrei
Department of Anaesthesia and Intensive Care, University Hospital, S-58 185 Linkoping, Sweden; Department of Clinical Pharmacology, University Hospital, S-58 185 Linkoping, Sweden

The concentration of propofol in and surrounding the human brain during propofol anaesthesia is unknown. We measured simultaneously the concentration of propofol in cerebrospinal fluid (CSF) from an indwelling intraventricular catheter and the concentration in arterial blood in five neurosurgical patients before, during induction (at 2.5 and 5 min) and during a maintenance propofol infusion (at 15 and 30 min). After induction of anaesthesia with propofol 2 mg kg-1, anaesthesia was maintained with an infusion of 8 mg kg-1 h-1 for 15 min and then reduced to 6 mg kg-1 h-1. The plasma concentration of propofol increased rapidly during induction and reached a plateau concentration of mean 2.24 (SD 0.66) micrograms ml-1 after 5 min. The concentration of propofol in CSF showed a slower increase during induction and remained almost constant at 35.5 (19.6) ng ml-1 at 15-30 min after induction. The CSF concentration of propofol that we measured was 1.6% of the plasma concentration and consistent with the high protein binding of the drug in plasma.
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