[Relationship between changes in estimated and measured blood concentrations of propofol and serum albumin concentration during propofol anesthesia: effects of intraoperative bleeding (a case report)].
We investigated the effect of intraoperative bleeding on the changes in estimated and measured blood concentrations of propofol, and the relationship between anesthetic effect of propofol and serum albumin concentration in a patient undergoing prostatectomy during propofol/epidural anesthesia. The rate of propofol infusion was titrated to keep the BIS value about 50. The estimated blood concentration of propofol calculated by ConGrase, a program for on-line simulation of blood propofol concentration, was monitored during anesthesia. Blood samples were obtained at nine points during surgery and the blood concentrations of propofol and albumin were measured postoperatively. When the amount of bleeding reached about 2000 mg, the difference between estimated and measured blood concentrations of propofol did not increase. As the serum albumin concentration decreased, the concentration of propofol to keep bispectral index about 50 decreased. This study suggests that the change in serum albumin concentration following intraoperative bleeding is an important factor in the anesthetic effect of propofol.
Kurehara
K
K
Surgical Center, Nara Medical University, Kashihara.
Takahashi
M
M
Hamasaki
T
T
Kitaguchi
K
K
Furuya
H
H
D000368:Aged; D000767:Anesthesia, Epidural; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous / Q000097:blood*; D016063:Blood Loss, Surgical; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative; D015742:Propofol / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery; D012709:Serum Albumin / Q000032:analysis*
D018686:Anesthetics, Intravenous; D012709:Serum Albumin; D015742:Propofol