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BJA Advance Access published online on July 23, 2008
British Journal of Anaesthesia, doi:10.1093/bja/aen210
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Effects of propofol on human microcirculation

M. Koch1, D. De Backer2, J. L. Vincent2,*, L. Barvais1, D. Hennart1 and D. Schmartz1

1 Department of Anaesthesiology
2 Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles (ULB), Route de Lennik 808, B-1070 Brussels, Belgium

* Corresponding author. E-mail: jlvincen{at}ulb.ac.be

Background: It is increasingly believed that acute microvascular alterations may be involved in the development of organ dysfunction in critically ill patients. Propofol significantly decreases vascular tone and venous return, which can induce arterial hypotension. However, little is known about the microcirculatory effects of propofol in healthy humans.

Methods: We conducted a prospective, open-labelled trial in 15 patients anaesthetized by propofol for transvaginal oocyte retrieval. The sublingual microcirculatory network was studied before, during, and after propofol infusion using orthogonal polarization spectral imaging.

Results: Mean (SD) calculated propofol effect-site concentration was 6.5 (1.8) µg ml–1. During propofol administration, systemic haemodynamic and oxygenation variables were unchanged, but total microvascular density decreased by 9.1% (P<0.05). The venular density remained unchanged, but the density of perfused capillaries was significantly reduced by 16.7% (P<0.05). Microcirculatory alterations resolved 3 h after discontinuation of the propofol infusion.

Conclusions: Propofol infusion for anaesthesia in man reduces capillary blood flow.

Keywords: blood, flow; oxygen, consumption; oxygen, tissue; oxygen, transport; tissue perfusion; pharmacology, propofol


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Is a Decrease in Capillary Density Dangerous
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British Journal of Anaesthesia, 3 Jan 2009 [Full text]

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