title: Propofol infusion associated metabolic acidosis in patients undergoing neurosurgical anesthesia: a retrospective study.
abstract: OBJECTIVE
  Propofol and volatile anesthesia have been associated with metabolic acidosis induced by increased lactate. This study was designed to evaluate changes in pH, base excess (BE), and lactate in response to different anesthetic agents and to characterize propofol infusion-associated lactic acidosis.
  
  
  METHODS
  The medical records of patients undergoing neurosurgical anesthesia between January 2005 and September 2012 were examined. Patients were divided into 2 groups : those who received propofol (total intravenous anesthesia, TIVA) and those who received sevoflurane (balanced inhalation anesthesia, BIA) anesthesia. Propensity analysis was performed (1 : 1 match, n=47), and the characteristics of the patients who developed severe acidosis were recorded.
  
  
  RESULTS
  In the matched TIVA and BIA groups, the incidence of metabolic acidosis (11% vs. 13%, p=1) and base excess (p>0.05) were similar. All patients in the TIVA group who developed severe acidosis did so within 4 hours of the initiation of propofol infusion, and these patients improved when propofol was discontinued.
  
  
  CONCLUSIONS
  The incidence of metabolic acidosis was similar during neurosurgical anesthesia with propofol or sevoflurane. In addition, severe acidosis associated with propofol infusion appears to be reversible when propofol is discontinued.
authors.affiliation: Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea.
authors.forename: Yoon Ji
authors.initials: YJ
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul National University, Seoul, Korea.
authors.forename: Min Chul
authors.initials: MC
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Lim
authors.affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Seung Zhoo
authors.initials: SZ
authors.lastname: Yoon
authors.affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Suk Min
authors.initials: SM
authors.lastname: Yoon
authors.affiliation: Department of Nutrition, Food Service Management, College of Industrial Science, Kongju National University, Gongju, Korea.
authors.forename: Hei Ryeo
authors.initials: HR
authors.lastname: Yoon
keywords: Acidosis; Neurosurgery; Propofol