title: Impact of effect-site concentration of propofol on cardiac systolic function assessed by tissue Doppler imaging.
abstract: OBJECTIVE
  To evaluate the relationship between effect-site concentration (CE) of propofol during total intravenous anaesthesia (TIVA) and cardiac systolic function using tissue Doppler imaging (TDI) in patients undergoing cardiovascular procedures.
  
  
  METHODS
  Stepwise increments of CE of propofol of 1.0, 2.0, 3.0 and 4.0 µg/ml (modified Marsh model) were achieved using a target-controlled infusion device. Transthoracic echocardiographic assessments using TDI were performed for each CE of propofol and corresponding systolic myocardial velocity (s'), mean arterial blood pressure (MAP), heart rate (HR) and bispectral index (BIS) were evaluated.
  
  
  RESULTS
  Data from 31 patients were analysed in this prospective study. The s' velocity decreased with increasing propofol CE and values recorded at propofol CE 3.0 and 4.0 µg/ml were near or below 8 cm/s indicating abnormal cardiac systolic function. MAP, HR and BIS also decreased with each propofol CE increment.
  
  
  CONCLUSIONS
  Although the recommended dosage for propofol is up to 4.0 µg/ml, caution should be taken when using propofol concentrations above 2.0 µg/ml during TIVA in patients with underlying cardiovascular diseases.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Chung-Sik
authors.initials: CS
authors.lastname: Oh
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Yungu
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Woon-Seok
authors.initials: WS
authors.lastname: Kang
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Korea Institute of Biomedical Science and Technology, Konkuk University School of Medicine, Seoul, Korea yshkim75@daum.net.
authors.forename: Seong-Hyop
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000368:Aged; D013504:Cardiovascular Surgical Procedures; D003710:Demography; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000187:drug effects / Q000503:physiopathology*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000494:pharmacology*; D013599:Systole / Q000187:drug effects*; D018608:Ultrasonography, Doppler
chemical_list: D015742:Propofol
keywords: Propofol; cardiac systolic function; target-controlled infusion; tissue Doppler imaging