[Propofol pharmacokinetics in a patient with TSH producing pituitary adenoma].
We investigated propofol pharmacokinetics in a patient with secondary hyperthyroidism caused by thyroid stimulating hormone (TSH) producing pituitary adenoma. Laboratory data indicated thyrotoxic state with elevated TSH, FT3 and FT4 levels. General anesthesia was maintained with a doubled propofol infusion rate (8-10 mg.kg-1.hr-1) compared to our standard procedure. During 370 min of infusion, propofol concentrations in arterial blood were kept within optimal ranges (2-4 micrograms.ml-1). Although the clearance of propofol was high (2.8 l.min-1) because of the thyrotoxic state, the patient showed delayed recovery from anesthesia. The half-life of blood propofol after the termination of infusion exceeded 30 minutes (normal: 10-15 minutes). We conclude that the delayed recovery was due to the accumulation of propofol in the adipose tissue during long-term infusion in spite of the increased propofol clearance.
Ishizuka
S
S
Department of Anesthesiology and Intensive Care Medicine, School of Medicine, Kanazawa University, Kanazawa 920-8641.
Tsubokawa
T
T
Yamamoto
K
K
Kobayashi
T
T
D000236:Adenoma / Q000150:complications / Q000378:metabolism*; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000493:pharmacokinetics*; D006207:Half-Life; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000378:metabolism*; D015742:Propofol / Q000493:pharmacokinetics*; D013972:Thyrotropin / Q000096:biosynthesis*
D018686:Anesthetics, Intravenous; D013972:Thyrotropin; D015742:Propofol