Effects of propofol on human microcirculation.
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) microg 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.
Koch
M
M
Department of Anaesthesiology, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, B-1070 Brussels, Belgium.
De Backer
D
D
Vincent
J L
JL
Barvais
L
L
Hennart
D
D
Schmartz
D
D
D000328:Adult; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D002196:Capillaries / Q000187:drug effects / Q000473:pathology; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008833:Microcirculation / Q000187:drug effects*; D008859:Microscopy, Polarization / Q000379:methods; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies; D014059:Tongue / Q000098:blood supply
D018686:Anesthetics, Intravenous; D015742:Propofol