[Effects of propofol on blood concentration of cyclosporine].
OBJECTIVE
This study was designed to assess whether propofol modifies the blood concentrations of cyclosporine and lipoproteins, which bind cyclosporine.


METHODS
Prospective open study.


METHODS
Fifteen consecutive grafted patients, scheduled for surgery allowing them to resume their oral treatment postoperatively. Their immunosuppressive treatment, included cyclosporine (Cy A), at a steady-state dosage.


METHODS
Blood samples were drawn and residual Cy A blood concentrations were measured the days before and after anaesthesia and before and immediately after discontinuing the propofol infusion. Serum triglycerides, cholesterol, high-density lipoprotein (HDL) concentrations were measured before and immediately after discontinuing the propofol infusion.


RESULTS
The 15 patients were given propofol by infusion for 30-210 min (mean 85 +/- 59 min). They received a total dose of propofol of 696 +/- 497 mg, a total fentanyl dose of 175 +/- 82 micrograms, and a total midazolam dose of 2.8 +/- 0.8 mg. The residual cyclosporine blood concentrations were similar the day before (142 +/- 47 ng.mL-1) and following anaesthesia (128 +/- 46 ng.mL-1) (P = 0.08). Serum cholesterol concentrations were not significantly influenced by propofol infusion, but serum triglycerides levels increased (1.46 +/- 0.66 vs 1.97 +/- 0.81 g.L-1), and HDL and LDL levels decreased (0.54 +/- 0.20 vs 0.47 +/- 0.18 g.L-1; 1.44 +/- 0.42 vs 1.28 +/- 0.37 g.L-1).


CONCLUSIONS
Propofol by infusion does not modify the cyclosporine concentration. It is concluded that propofol may be a suitable agent for intravenous anaesthesia in cyclosporine treated patients, provided a close postoperative monitoring of cyclosporine blood concentrations is maintained.
Pertek
J P
JP
Départment d'anesthésie-réanimation, CHU de Nancy-Brabois, Vandaeuvre, France.
Chaoui
K
K
Junke
E
E
Artis
M
M
Coissard
A
A
Frisoni
A
A
Meistelman
C
C
D000328:Adult; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D016572:Cyclosporine / Q000097:blood*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies; D011485:Protein Binding / Q000187:drug effects
D018686:Anesthetics, Intravenous; D007166:Immunosuppressive Agents; D008074:Lipoproteins; D016572:Cyclosporine; D015742:Propofol